Such is the case for the link between maternal rubella infection and autism rates.

It turns out that there is a long-established academic literature connecting maternal rubella infection with subsequent neurological dysfunction, including autism.

When I was a child, sixty years ago, people used to talk about the risks of viral infection during pregnancy. There was a strong collective memory of infants being born with congenital rubella and associated disabilities.

At that time, the risks were associated with defects in the eyes and the ears rather than anything going wrong with the brain. (1)

It was only in the 1970s that people started to establish a strong connection between rubella and autism.

What’s more, the risks then appeared to be abated by successful vaccination campaigns that reduced maternal exposure to the disease.

Us schoolgirls were given the rubella jab from 1970, and this was subsequently rolled into the Measles, Mumps and Rubella (MMR) vaccine that was given to children from 1988.

Our experience of rubella has largely disappeared in this time.

As ever, however, this is not as straight-forward as it might seem.

While the vaccines have stopped almost all maternal infection, particularly in countries like ours, the neurological problems in our children are now getting worse.

My reading of the literature points to a problem delayed rather than a problem resolved.

The childhood autism symptoms associated with maternal rubella infection in the 1960s are now being seen, albeit more mildly in some cases (but not all), in the children born to vaccinated mothers who have vaccinated children. There are uncanny parallels in the cases described in seminal research papers tracking children with congenital rubella-related autism, then and now.

I can see my son’s profile jumping out of the page when reading articles written fifty or sixty years ago. There are also descriptions of children with milder forms of neurological damage that reflect the current upsurge in ADHD, apraxia and dyslexia.

There is an obvious risk that vaccine-administered rubella, especially when it is given in combination with other viruses (measles, mumps and varicella/chicken pox) and adjuvants, is responsible for the re-emergence of autism in some children today.

Many parents report a post-vaccine rash that looks like german measles and a high fever, followed by the onset of chronic immune problems and neurological regression, just as was reported in children born with congenital rubella in the 1960s. This happened to our precious son more than two decades ago and it continues to happen to children all over the world.

Telling us to stop talking about it won’t make it go away.

In the mid-1960s, there was an epidemic of rubella or german measles in America. This provided the opportunity to study some of the thousands of children born to mothers who were infected with rubella during pregnancy. (2)

A multidisciplinary Rubella Birth Defects Evaluation Project was established by researchers at New York’s Medical Center [sic], to look at the problems and the provision of services for the children affected.

Stella Chess, Professor of Child Psychiatry, reviewed the psychological and psychiatric impacts by obtaining retrospective reports from parents, reviews from schools and/or medical practitioners, and making direct observations of the children at play. The results are a fascinating and long-forgotten testament to the virtue of careful observation and longitudinal work.

Four things really stand out:

First, she found that as many as 91 (or 37%) of the 243 children had ‘mental retardation’, a much higher rate than was usually found (3%).

Second, she found that a very significant number of the children had symptoms of autism – then a very rare and newly established condition.

Ten had all the characteristics of classic autism and another 8 had a ‘partial syndrome of autism’.

She later said that this latter group were characterised by “the occurrence of transitory fleeting expressions of recognition of another person” that compromised Leo Kanner’s focus on a lack of affective human contact and interest. She included those who displayed ‘language abnormalities’ and ‘stereotypical relations to the environment’ but acknowledged that they were more emotionally connected than those in the ‘full autism’ group. (3, 4)

Third, the study produced an autism rate of 412 per 10,000 children for classic autism and 329 per 10,000 for the partial syndrome, comprising 741 per 10,000 or 7.41% of the children affected. Furthermore, when she re-examined the cohort a few years later, she identified an additional 4 cases (1 full and 3 partial) who had subsequently developed autism symptoms. This increased the prevalence to 905 per 10,000 children or 9.05%. This was more than 200 times greater than the standard prevalence for autism found at the time. She compared her rate to:

A study in Middlesex UK, in 1964 that looked at children aged between 8 and 10 had found a rate of 2.1 per 10,000 with classic autism and 2.4 per 10,000 with partial autism, comprising an overall rate of 4.5 per 10,000 (or 0.045%). (5)

A rigorous survey of children in Wisconsin in 1970 that found a prevalence of 0.7 per 10,000 for classic autism and 3.1 per 10,000 if those with a diagnosis of childhood schizophrenia were included as well (a rate of 0.031%). (6)

Even now, 60 years later, Chess’ rates are well above the expected prevalence, and in 2022, research identified 3.2% (or 1 in 31) of 8-year-old children in America as having autistic spectrum disorder. (7).

Fourth, Chess found no evidence for the ‘schizophrenogenic’ or ‘refrigerator’ parents who were blamed for causing autism at the time. Nor could she see an obvious genetic, ethnic or socio-economic connection. For her, the rubella pointed to autism having ‘an organic etiology’ (p.46). She was moving away from the dominant psychosocial model towards finding a biological cause:

“The common denominator in our sample is that all the children were at risk for prenatal invasion of the CNS [Central Nervous System] by rubella virus. It seems reasonable to speculate that the common component in our autistic children is brain damage.” (Chess, 1971, 45).

Another group of scientists from Baylor University in Texas, led by Murdina Desmond (another woman) were conducting similar studies and were able to endorse this approach by finding rubella in the Cerebral Spinal Fluid (CSF) of infants who had been exposed to rubella in utero, relating this to the severity of the symptoms displayed. (8)

Table from Desmond et al. (1967, p.319).

Later research from other research groups suggested that children with congenital rubella had problems in their innate rather than adaptive immune response. The children struggled to clear the virus due to defects in the cellular immune response even though they mounted a successful antibody response. These authors raised the possibility that infection during foetal life induces a form of immune tolerance or immune unresponsiveness to the virus, disrupting the normal T-cell response. (9, 10)

However, the longitudinal studies indicated that symptoms could change over time. And as Desmond and colleagues reported:

“Between 6 and 12 months of age, the patient group began to diverge. Some improved rapidly within limits imposed by handicaps; others improved more slowly or showed a more definite type of neurological impairment. Fifteen virtually ceased to improve between 12 and 18 months. Eight of the 15 became increasingly withdrawn and autistic in behavior [sic].” (Desmond et al, 1967, p.328)

Desmond and colleagues suggested that persistent rubella infection explained the dynamic presentation of neurological symptoms, including autism, over this time. Some children were affected in utero and then recovered, others had ongoing rubella infection in the post-natal period, and some were much more affected than others.

Similarly, in her follow up study, Chess found that the autism symptoms were subject to change.

Chess revisited 17 of the 18 children with autism when they were 8 or 9 years old, and she also identified another 4 children who had not been categorised as autistic in the first wave of research. (3)

Each child was subject to an intense assessment and review of parental and school reports. Some had worsened and some had improved.

Chess hypothesised that this was a manifestation of chronic viral infection and encephalitis that could wax and wane over time.

It is also worth noting that Desmond and colleagues in Houston were able to track 29 apparently higher functioning children into late childhood, and they found that many had the symptoms we would now call ADHD, dyslexia or dyspraxia. The combination of attention deficit, motor and learning difficulties and problems with social communication and relationships echo many of the most common difficulties facing children today. (11)

Finally, another group of scientists reported a case in utero rubella infection persisting and being apparently re-activated many years later. A twenty-year old man was found to develop normally until a regression that hit in his teens, reactivating the dormant rubella. He suffered worsening seizures, ataxia, speech problems and learning difficulties and a post-mortem investigation found signs of chronic and progressive encephalitis and high levels of rubella antibodies in his blood and CSF. (12)

We know now that these effects are further mediated by the maternal immune system and its activity during gestation both before and after any kind of infection. Maternal Immune Activation (MIA) is an established cause of autism and other neuropsychiatric disorders, and it has been reliably replicated in human and animal studies. (13)

There is strong evidence that MIA can prime a child for a subsequent ‘hit’ to their neurological development, even years after birth, with further complications associated with changes in the microbiome.

As Estes and McAllister (2016) explain: “This figure depicts the current model for how MIA leads to psychiatric disorders in offspring. Infection leads to release of pro-inflammatory cytokines and activation of T_H17 cells in the mother’s bloodstream. A combination of genetic background, autoimmune status, and second hits during childhood and adolescence combine to increase the likelihood of offspring developing psychiatric disorders as [children and] adults.”

Natural infections as well as vaccines cause immune activation in mothers who then prime their infants who can potentially fail to react decisively to the infections and vaccinations they have.

When our son regressed into autism he displayed many of the symptoms associated with rubella viral infection as described by Chess, Desmond and others. He had his Measles Mumps and Rubella (MMR) and Meningitis C vaccinations on the same day, after which he had an all-over rash and a very high temperature; and I’ve told the story before.

Remarkably, he subsequently displayed the same toe walking that Desmond and colleagues described in their study, and this persisted for months:

“Walking on flexed toes or the ball of the foot with heels lifted was the most common mode of early walking in the majority of children and persisted in some to 18 months.”

Our son also still likes to deploy the “Prolonged hand regard, waving of spread fingers in front of the eyes” that they also describe (Desmond et al, 1967, p.321).

Aspect of a rubella response and/or viral encephalitis are being seen in children like mine. These children may similarly struggle with persistent viral infection and deficit cellular immunity, as was found in the early research, but today, no one looks. (9, 10)

The drive to use polyvalent vaccines at ever-shorter timescales is likely to make things much worse. The children most exposed to MIA and/or those with immune deficits that result in higher levels of viral persistence, are likely to suffer the most.

From 1 January 2026, England began to administer the Measles, Mumps, Rubella and Varicella (MMRV) vaccine to children at 12 and 18 months old. This is a step up from three to four viruses, and it is being given much earlier than was done in the past.

The vaccine is administered to children born to mothers who were also vaccinated, many of whom have immune activation and autoimmunity, and there is no screening for maternal or infant immune response and likely reaction. It is a recipe for untold disasters to come.

We need to ensure maternal health and limit exposure to viruses like rubella, but we can’t do it by pretending everything’s fine. It is not. The evidence is there in the brains and behaviour of our children, and it is backed up in journal articles that need to be read.

Sadly, the scientific community is no longer able to do the kind of careful observational, longitudinal and clinical research that Chess, Desmond and others were able to do. Our son’s autism was triggered by a viral episode, but no NHS doctor was willing was investigate this.

Furthermore, there has been no attempt to explore the obvious immunological aspects of his condition nor his immune inheritance from me.

There is a desperate need to rethink the politics of autism science so that we can return to the careful identification of biological aetiology as Chess, Desmond and others were trying to do.

References:

1. Gregg N. M. (1941) Congenital cataract following German measles in the mother. Transactions of the Ophthalmology Society of Australia, 3, 35–46.

2. Chess, S. (1971) Autism in children with congenital rubella. Journal of Autism and Childhood Schizophrenia, 1, 33-47.

3. Chess S. (1977) Follow-up report on autism in congenital rubella. Journal of Autism and Childhood Schizophrenia, March, 7, 1, 69–81.

4. Kanner L. (1943) Autistic disturbances of affective contact. Nervous Child, 2, 3, 217–250.

5. Lotter, V. (1966) Services for a group of autistic children in Middlesex, in J. K. Wing (Ed), Early Childhood Autism. Oxford: Pergamon Press.

6. Treffert, D. A. (1970) Epidemiology of infantile autism. Archives of General Psychiatry, 22, 431-438.

7. Maenner, M. J., et al. (2025) Prevalence and Early Identification of Autism Spectrum Disorder Among Children Aged 4 and 8 Years — Autism and Developmental Disabilities Monitoring Network, 16 Sites, United States. Morbidity and Mortality Weekly Report (MMWR) Surveillance Summaries, 74, 2.

8. Desmond, M.M. et al. (1967) Congenital rubella encephalitis. Journal of Paediatrics, 71, 311-331.

9. Fuccillo D. A. et al. (1974) Impaired cellular immunity to rubella virus in congenital rubella. Infection and Immunity, 9, 1, 81-84

10. Buimovici-Klein, E. et al. (1979) Impaired cell-mediated immune response in patients with congenital rubella: correlation with gestational age at time of infection. Pediatrics, 64, 5, 620-626.

11. Desmond, M. M. et al. (1978) The longitudinal course of congenital rubella encephalitis in nonretarded children. The Journal of Pediatrics, 93, 4, 584-591.

12. Townsend, J. J., Wolinsky, J. S., and Baringer, J. R. (1976). The neuropathology of progressive rubella panencephalitis of late onset. Brain, 99, 1, 81-90.

13. Estes, M. L. and McAllister, A. K. (2016) Maternal immune activation: Implications for neuropsychiatric disorders. Science, 353 (6301), 772-777.

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The university put out a long press release including glossy images marking the arrival of the youngest ever (then 37) black person to be appointed to a professorship. He was severely autistic as a child and yet had triumphed against all the odds:

“Arday has faced many personal challenges – notably being diagnosed, at the age of three, with a form of Autism Spectrum Disorder which meant he was unable to speak until he was 11, or to read or write until he was 18. Other parts of his story … [further] epitomise the significant barriers that neurodivergent individuals, those from lower socio-economic backgrounds, and Black, Asian and Minority Ethnic people face when trying to build careers in the sector.”

Here was a young man who ticked almost all the boxes most beloved of the left.

He was black and working class with a severe disability.

What’s more, he had experienced the kind of profound autism that means you can’t speak. He left school before he could read.

Somehow, against all the odds, Arday had mustered the strength of character get an undergraduate degree, two master’s degrees and a PhD. He went from idiocy to intellectual genius in just twenty years.

Arday exemplified the power of education to transform everything, even profound autism. The senior leadership of the university were over the moon.

At the time of his appointment, in March 2023, Arday did a live interview with Kay Burley on Sky News. He looked her straight in the eye (not easy for someone with autism) and told her: “I was diagnosed with Autism Spectrum Disorder when I was three. It was a hybrid of autism, Asperger’s Syndrome and Global Developmental Delay. It’s been well publicised now, but I didn’t learn to speak until I was 11 and I didn’t learn to read or write until I was 18.”

I remember hearing Arday saying similar things on Radio 4, likely when he was guest editing the Today programme in December 2023.

I remember thinking, how did this happen? How could this be? How could a young man go from having profound autism to being a professor at Cambridge in just twenty years? How did he catch up on all the learning he lost? How can he be handling the challenges of an academic position at the top of his field? Why are we not hearing more about what allowed him to recover so much?

Sadly of course, we now know the severity of his autism was likely just one of his lies.

It was probably a fabulous fabrication that went with all the others things he said about being an all-round champion who ran marathons, raised millions for charity and loved saving the poor.

As far as we know, Arday was never autistic and there is no miracle recovery story to tell.

Indeed, according to an old school colleague, he never stopped talking and clowning about.

What’s more, the details of his autism story couldn’t be true.

Donna-Louise Flowers has worked out that if Arday was assessed when he was three (around 1988), he would not have been diagnosed with anything like the ‘hybrid’ condition he claims.

She points out that at that time, “Asperger’s syndrome was not an official diagnostic category. It only entered the major classification systems in the early 1990s (ICD-10 in 1992/93 and DSM-4 in 1994) … [and] even after it became an official diagnosis, a defining requirement of Asperger’s was the absence of any clinically significant general delay in language.”

Similarly, Global Developmental Delay, was only formally included in DSM-5 (from 2013), to be used as a transitional category for very young children who should later be re-assessed for learning disability. It was not available as a diagnostic category when Arday was being assessed.

For Flowers: “The story … requires a diagnosis that was not formally available at the time, applied to a language profile that would later have ruled the same diagnosis out. No independent clinical records have ever been produced to support [the case that Arday has made]”.

However, it is telling that autism provided the perfect cover for Arday’s ascent to the top.

Autism makes you somewhat untouchable as you can claim to be ‘masking’ if anyone asks.

Autism gives you cover for any misdemeanours like plagiarism (which Arday puts down to the ‘mimicry’ associated with autism).

Autism allows you to float effortlessly in the DEI ether as a special class of person beyond the scrutiny of neurotypical types.

Cambridge University is home to a world-leading research centre on autism.

Its director, Professor Sir Simon Baron-Cohen has vigorously defended Arday yet never asked any pressing questions about the ‘autism’ or the miraculous recovery – in public at least.

Baron-Cohen was happy to write a puff for a book of Arday’s on ‘neurodiversity’ and social justice (Princeton University Press, 2025) – claiming it demonstrated “great originality” - yet he hasn’t mustered the mental puff to query the facts.

This matters. It really does.

The parents of children with profound autism want and need answers.

We want to believe that our children can recover.

We live that dream every day.

We need research into the handful of children who DO recover and proper investigation into the biological changes that underpin their success.

Professor Deborah Fein from the Department of Psychological Sciences at the University of Connecticut has published research into the relatively small group of children who do ‘grow out’ of profound autism. Fein and colleagues have identified children who displayed all the symptoms of profound autism in early life (evidenced in medical reports, family videos and testimony) only to then get back on track with their peers. The children achieved what she and colleagues initially called ‘optimal outcomes’ but more recently refer to as Loss of Autism Diagnosis or LAD. Her paper looks at the history of reports and findings from longitudinal studies that identify similar trends and it seems remarkable that so little fanfare is made of this work.

Fein’s 2013 paper (frontsheet above) aimed to address the pressing questions that haunt all autism parents when they first get the news:

Can our children recover? Are the stories of recovery real or made up? Is this rare or were the children initially misdiagnosed and/or still facing challenges in social life, communication and behaviour? Can this happen to me?

Fein and colleagues’ study compared 34 children who had apparently recovered (the Optimal Outcomes or ‘OO group’), with 34 typically developing children (the ‘TD group’) and 44 children with a diagnosis of high functioning autism (the ‘HFA group’).

The summary findings were that the “OO and TD groups’ mean scores did not differ on socialization, communication, face recognition, or most language subscales, although three OO individuals showed below-average scores on face recognition. Early in their development, the OO group displayed milder symptoms than the HFA group in the social domain, but had equally severe difficulties with communication and repetitive behaviors.”

These children had a verified early diagnosis of autism who then recovered and lost their diagnosis by the time of the study. The study, and the film released to accompany the research, argued that this was due to intensive behavioural and speech therapy, but we really need to know more.

We need families who have seen this happen, to come forward to take part in research. We need clinicians to take the claims seriously and start to explore the biological processes that accompany such dramatic changes in function, allowing the body and brain to get back on track. We need to repeat the recent study that found up to 9% of children recover this way.

There has already been similar research in Turkey and both groups argue that a small number of autistic children can recover, giving us hope to learn and do more.

Jason Arday fuelled the dream that children can recover from profound autism.

The world’s leading authority on autism and all his colleagues at the university fuelled it as well.

Even now, in his resignation letter Arday repeats the claims about his autism, saying:

“To become the youngest Black professor in the University’s history was something I could scarcely have imagined as a child growing up with a diagnosis of autism, unable to speak until I was eleven years old.”

Now that the university is belatedly investigating how it managed to appoint Arday to a university post, they should dig into this claim.

If it is true, they should charge Baron-Cohen with finding out how Arday recovered from the kind of profound autism that is devastating families and crippling public services across the world.

If it is not true, they should apologise to the parents of children with profound autism, for turbo-charging fake news and misinformation. For raising false hope. For spreading confusion and lies.

Whatever happens, we should be conducting proper longitudinal research projects to explore the trajectory of children with profound autism. Once diagnosed, their biological functioning should be properly assessed and regularly reviewed. We need to identify the children who end up as LADs. We need to be able to retrospectively identify what was done differently, if anything, and to understand the role of educational therapies, medical interventions and other life events that allowed them to develop this way.

At present, the British NHS does none of these things. Its clinicians diagnose children with profound autism and send them to the special educational needs department and the benefit queue. There is no intelligence gathering or capacity in the system at all. It’s as if no-one cares.

This is the real crime at the heart of the Jason Arday autism story.

Jason Arday is a modern-day fool who has inadvertently exposed the remarkable stupidity of the intellectual court. It is telling that he wore the cloak of autism to cover his tracks. It is the perfect identity category to attract sympathy and avoid scrutiny. It means almost nothing, even to the people directing research in the field.

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You will have seen the mugs, cards and posters. They can be found in every gift shop across the land. They declare we should Keep Calm and Carry On!

Reflecting the origins of the slogan in government-backed propaganda to foster support for the Second World War, the call to ‘keep calm’ was designed to shut people up.

This slogan comes to mind every time there is a new announcement about the autism rates. The numbers go up and we are told to ‘Keep Calm - There is nothing to see!’

Any rise in the rate is just the product of better awareness, broader criteria and greater inclusion.

The same propaganda is repeated in one country after another, in one journal article after another, in one news outlet after another, year after year.

This is despite the obvious fact that public services are buckling under the strain of trying to diagnose, educate and fund rising numbers of people with lifelong neurodevelopmental disorders like autism and ADHD.

The latest example concerns the data for France.

When our son was diagnosed with severe (or profound) autism in early 2008, I remember being told that France had much lower rates of autism than the UK. It was seen as the outlier in Europe.

People speculated that it was something to do with the quality of the food and the practice of psychoanalysis (with the implication that this involved misdiagnosing people as having psychological trauma rather than autism), but the rates were always the ‘best’. There was a popular notion that France didn’t have the neurodevelopmental disorders that were plaguing the West.

That is no longer the case.

A new academic paper reports that rates are going up, dramatically, even in France.

This study, published in the Journal of Autism and Developmental Disorders, reports on a longitudinal data set collected in the county of Haute-Garonne, which includes the city of Toulouse, in the southwest of France. The region has a registry that systematically records all children born since 1995 during the calendar year in which the child reaches the age of 8 (regardless of their place of birth) who have been diagnosed with autism by a healthcare professional no later than the year they turn 8.

The Haute-Garonne region in France

The authors of the paper have looked at the autism rates, noting that what used to be a very low level of incidence – 2.1 per 1,000 children (0.21% or 1 in 500) in 2003 – had risen to 13.5 per 1,000 (1.35% or 1 in 74) in 2024. This is an increase of more than 500% in just 20 years.

Imagine if cancer rates had gone up by 500% in just twenty years. People would be turning the air blue with cries of ‘sacré bleu’ and demanding something was done.

However, as ever when it comes to autism, the paper is more ‘rien à voir’ than ‘sacré bleu’.

The data indicate that most of the rise has been in children who don’t have learning disabilities or intellectual impairment. They don’t have the kind of ‘classic autism’ that might be a threat. However, this rather downplays some important details that are buried in the statistical meat of the paper.

First, the number of cases with learning difficulties or intellectual impairments or what we would call ‘classic autism’ has more than doubled over this time. Rates have risen from 1.7 per 1,000 (0.17% or 1 in 588) in 2003 to 4.3 per 1,000 (0.43% or 1 in 223) in 2024, a rise of 153%. We can assume that this is an accurate representation of the numbers with ‘classic autism’.

Second, the children with more profound intellectual disability were found to have higher levels of sleep disorders (14% of cases) and eating disorders (just over 20% of cases) which reflects the pattern of comorbidities associated with this group in other locations as well.

Third, it is important to remember that all the other children with a diagnosis must have evidence of lasting impairment in their social skills, communication capacity and flexibility of thought. This is not nothing – just ask people who have what used to be called Aspergers or high-functioning autism.

Fourth, as many as 1 in 5 of these higher functioning children had been given an additional diagnosis of ADHD as well as autism, adding to the impairments and their likely need for support.

Fifth, the ratio of boys to girls was as high as 5:1 in 2024 suggesting that it is young men who remain more vulnerable to neurological disorders, despite the emphasis on ‘catch-up’ diagnosis for women and girls that has been going on in many parts of the world. As many as 2.11% of boys aged 8 (1 in 47) were diagnosed with autism in 2024, which is shockingly high, especially for France where the rates were always much lower than those found in other parts of the world.

This data puts France in the middle of the rates for boys aged 8 as reported for the United States (although the rate is for 2022 and is likely to be higher now) and England (where the data is almost a decade out of date and likely to be much higher now).

Comparison of the autism prevalence rates for boys (aged 8) in the Haute-Garonne, France, with those in the USA and England

When they looked at the 625 children most recently diagnosed with autism in Haute-Garrone - children born between 2014 and 2016, who turned 8 in the final year of the registry entries - the authors of the French study tried to identify any possible biological explanations for what had occurred.

Although these characteristics will overlap in some children, thereby compounding the likely effects, roughly 10% were born prematurely, and the same rate had a low birth weight (< 2500g). Double that number (22%) were born by caesarean section and 10% had been hospitalized in a neonatal unit.

There was a statistically significant relationship between having an older father and autism, but this association with age was not found in the mothers as well.

A genetic syndrome or chromosomal abnormality was found in 30 children (5%), with a possible link to autism in half of these cases. A malformation was found in 27 children, or 4% of cases (including cardiac malformation in 11 cases, cerebral malformation in six cases, and hypospadias in five cases).

Clearly, for a subset of children, there were obvious biological factors that underpinned the later diagnosis of autism, including risks associated with early birth, low birth weight, caesarean section and hospital care that I’ve covered before.

However, while they don’t mention it, and would never get published if they did, it is interesting to think about the immunological consequences of any vaccinations given to the mothers and their children over this time.

France has long had mandatory vaccines for Diphtheria (from 1938), Tetanus (from 1940) and Polio (from 1964). The government also mandated compulsory TB vaccination via BCG, between 1950 and 2007. We can assume that the parents and children in the Haute-Garonne study had this package of vaccinations as a minimum, although others were widely encouraged.

However, since January 2018, the French government has adopted a compulsory childhood vaccination schedule that looks very much like the rest of the west, moving from 3 to 11 vaccines (some of which are given more than once). They have added Pertussis (whooping cough), Haemophilus influenzae type b, Hepatitis B, Pneumococcal disease, Measles, Mumps, Rubella (given as ROR or MMR), and Meningococcal C disease to the established DTP (Diphtheria, Tetanus and Polio).

French parents are forced to complete this schedule if their child is to attend nursery, school or university and not surprisingly, compliance rates are reportedly high.

Thus, there is something of a natural experiment underway in France.

Autism rates were already going up but pressure on the immune system – caused by the growing vaccination schedule - might be getting much worse amongst the cohorts to come.

The European country which had the lowest autism rates might well be moving towards the top of the list and in this regard, the Haute-Garonne registry data represent political dynamite.

The entries collected for this year – 2026 – include the first cohort of 8-year-olds who have been through the period of mandatory vaccination for 11 rather than 3 diseases.

Repeating the study would be a great thing to do.

If the autism rates are found to have gone down, we can’t blame the burgeoning vaccine schedule, and conspiracy theorists can be put in the stocks. I will be very happy to eat humble pie.

If they have gone up, again, we have no choice but to repeat our demand for answers to the autism crisis - including scrutiny of the impact of the vaccination programme on the neurodevelopmental health of the next generation.

We certainly can’t keep calm and carry on.

The comfort blanket of complacency must eventually start to wear thin, and we can usually rely on the French to revolt before the rest of us do.

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One member of the group designed a logo for what was to be a new charity. He sketched out a single piece of a jigsaw puzzle and overlaid a crying child on the top.

https://www.autism.org.uk/in-our-words/decade-timeline

The logo perfectly reflected their need to understand the puzzle of autism that was blighting their lives.

Launched in January 1962, the new charity was called The National Autistic Society (NAS), and it aimed to:

· provide and promote day and residential centres for the support and education of autistic children;

· support parents of autistic children by facilitating the exchange of information;

· encourage research into autism;

· encourage more understanding and awareness of autism among medical professionals and the general public.

At that time, most people had never heard of autism. Medics were scratching their heads to understand why a child would display the symptoms associated with the condition. Parents wanted answers and the logo perfectly reflected their quest to know more.

The contrast with the situation today is remarkable.

Now, every classroom in every mainstream school is likely to have at least one pupil with autism. Every local authority provides and/or funds places in special schools for hundreds of children with profound autism and those with the most complex needs. Thousands of young people are unable to study or work due to their autism and related disabilities. The condition is bankrupting families, communities, councils and the national exchequer.

Most bizarrely of all, however, the political, research and medical establishment now want to normalise this. They tell us there is nothing out of the ordinary in having a child who can’t function, fit in or look after themselves. They adopt the language of ‘neurodiversity’ to suggest that everyone’s different and tell us it’s great.

The collective insanity is hard to believe.

These are the words that now appear on the NAS website to explain away the logo that launched their early campaigns:

“The first logo for the National Autistic Society was created by Gerald Gasson, who was a board member of the charity. This logo included the now-discontinued puzzle piece with a crying child. These days, associating autism with a puzzle piece as if ‘something is missing’ or depicting all autistic children as miserable is offensive and inaccurate. The sixties may not have been that long ago, but our understanding has come a long way.”

Even the charity founded by a group of pioneering parents has given up trying to find out what is causing the problem and what can be done to prevent it. The early support for research has given way to campaigns for greater awareness, more inclusion and turbo-normalisation.

What’s more, there is an inverse relationship between the scale of the problem and the desire to find out what has gone wrong.

In just 60 years, we have seen autism become a normal part of everyday life. Parents are encouraged to embrace it. Researchers are advised to keep their heads down.

The most disabled children and their families are paying the price.

For me, the NAS logo has always made sense.

As a parent, you are in the dark.

Our son developed normally until the middle of his second year when he developed a collection of very odd behaviours: toe walking, hand-flapping, jumping to a great height from a standing start (something that he can still do with aplomb), being terrified of a weathervane, rewinding his videos, repeating the same phrases over and over again, running off down the street as fast as he could.

At the same time, he suffered a cascade of physical symptoms that I’ve written about for the Tribune before: the eczema and obvious food intolerance, the crippling constipation, the insomnia and cognitive decline. We had no idea that this was autism and at the time, we thought it was some kind of chronic allergy as our older daughter had suffered similar signs of distress.

Almost two decades later, I’ve come to think of autism as a series of jigsaw puzzle pieces. Each one a sign of dysfunction, pointing to the biological aetiology of the condition, even though it is hard to see how each fits into the big picture on the front of the box. It’s all too easy to get stuck on one piece or lose sight of one altogether and the apparently isolated pieces are hard to connect.

The gut is a good example of this.

We know our children have problems with eating, digesting and excreting as well as having allergic reactions to food.

The mantra has always been to ‘heal the gut’ as though it will unlock the key to it all.

But ever since he was first diagnosed, our son has been on a gluten-free, dairy-free and processed-food-free diet. He has home-grown vegetables and butcher-bought meat. We cook everything from scratch and never eat out. In the past year, he has had long spells without laxatives – something we never thought would happen to us.

Now when we conduct tests to explore gut function, metabolites and the microbiome, the results are always remarkable for being largely unremarkable. While they are never great, they are never far off the norm.

Our latest test is just in. It shows a pattern associated with low level inflammation. There is only one elevated gastro-intestinal marker – Zonulin - which is just above the reference range:

He has adequate microbial diversity with borderline elevations of bacteria that produce hydrogen sulphide, Branch-Chain Amino Acids (BCAA) and beta-glucuronidase:

There is an elevation of ammonia with borderline high levels of lactate and histamine producing microbes:

I know it’s not great but it’s also not bad, and analysis of the phylum, genus and species level data shows similarly unremarkable trends.

Nothing stands out bar an unusually elevated level of the genus Acetatifactor (+2.27 above average) and two species of Bacteroides – parabacteroides distasonis (+4.21) and bacteroides intestinalis (+3.83).

Of course, it might be absence rather than presence that matters much more. The results showed a complete lack of bifidobacteria and lactobacillus and this might reflect why he regressed in the first place – something I’ve written about in the past.

But this brings me back to the jigsaw again.

All-too-often, the jigsaw pieces are a frustrating shade of grey and it can be hard to see the joins from one to the next.

Indeed, when it comes to the puzzle, we might be better off starting from the big picture and working down to its constituent parts. We know that the autistic brain doesn’t work as it should. The neurons are not getting the energy they need to power all the higher order processes that make our species such a success (speech, communication, social organisation and cognition) and these fail to develop in profound autism.

If autism is a manifestation of brain energy dysfunction – with an aetiology and symptom-profile that varies between individuals depending on the age of onset, genome and the triggers of the decline – there might be things we can do to improve the way the brain works.

It might be time to start with the whole jigsaw rather than focusing on one piece at a time.

This might be the next stage in the parent-led quest to understand the puzzle of autism.

And this recent paper suggests that it is:

The paper highlights the development of new research agendas that start with the brain regardless of the aetiology that caused the decline. It advocates whole puzzle science, connecting autism to a host of other medical conditions, helping us put the autism puzzle in a much bigger box. We need to get on with it, fast.

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This post asks what we have lost by forgetting regression, why it matters and what can be done about it.

We live in a society where increasing numbers of children are succumbing to serious physical and mental distress and disease.

Never a week goes by without an official report or statistic highlighting the scale of decline.

Just last week, the Children’s Commissioner for England Dame Rachel De Souza issued a shocking report highlighting the fact that 1 in 10, or more than a million, children had active referrals to mental health services in the previous year. The number of requests for suspected autism had gone up more than anything else - from 65,530 in 2023-4 to 96,393 in 2024-5; a rise of 47% in a year.

We are overseeing the collapse of the next generation and it’s not a good look.

Our forebears would have seen it as a terrible dereliction of our duty to God.

In Genesis [17, 5-7] we are told that God made Abraham: “a father of many nations. I will make you very fruitful; I will make nations of you, and kings will come from you. I will establish my covenant as an everlasting covenant between me and you and your descendants after you for the generations to come, to be your God and the God of your descendants after you.”

The generational succession is no longer secure. The covenant has been broken and worst of all, we lack the prophets and teachers who can lead us back to the light.

Our current crop of politicians and experts blame an assortment of strawmen for the horrors afflicting our youth. Moral outrage is directed at media tycoons, internet influencers, bad parents, benefit fraudsters, poor employment opportunities, weak community and divisions of wealth.

In all the huffing and puffing, there is no proper reckoning with the state of our health.

Seeing a child regress into severe or profound autism forces you to reflect on what has gone wrong. You witness the accumulating signs of catastrophic biological collapse in chronic eczema, constipation, insomnia, anxiety, loss of speech and self-harm – all of which wreck the life of your child.

The biological signals are blindingly obvious. They reflect a cascade of immune, metabolic, energy and neurological failures as our children lose the ability to perform the higher-order functions that have made our species such a success.

When scientists first started to document the trajectories of children like ours, they took detailed histories. They looked carefully at the symptoms. They explored the circumstances of the collapse. They tried to identify what had gone wrong. They took it seriously.

In his paper Über Dementia Infantilia: Verblödungsprozess im Kindesalter (On Dementia Infantalis: Mental regression in childhood) originally published in 1908 (and available in English translation in the Journal of Autism and Developmental Disorders in 2013), Theodor Heller documented 6 unusual cases encountered at his Institute for Handicapped Children in Vienna. These children all developed normally until the age of 3 or 4 and then regressed into what we would now recognise as profound autism. At least half of them were the children of doctors who brought them to the Institute after their collapse had occurred.

Heller was clearly shocked by the depth of regression affecting these children. He documented the associated changes that included incontinence, night terrors, insomnia, crying for no apparent reason, anxiety, tics, grimaces, strange mannerisms and odd postering. The children lost the ability to feed themselves and to speak. One boy was described as having zerstörungssucht - being addicted to destruction. Another was characterised as ‘windmilling’ with his arms.

One had a wet nurse who had been treated for syphilis and Heller queried the potential impact of the mercury that would have been unintentionally fed to the child. The children would also likely have had the small pox innoculations that were being used at that time and this might have triggered an immune reaction underpinning regression. Heller knew there must be a cause but he didn’t have the means to look very far beyond the symptoms being displayed.

100 years after Heller’s paper was published – in 2008 - we took our son to the Child Development Centre at St Ann’s Hospital in Haringey, North London, for assessment of the very same catastrophic collapse. He was 4 and a half years old. In an appointment that took an hour at most, we came away with a diagnosis of severe autism. There was no follow up. No further investigation. No suggestion of treatment. Nothing more to be done.

Heller would have recognised our experience. He would have diagnosed Dementia Infantalis (later called Heller’s Disease or Childhood Disintegrative Disorder (CDD)). He would have appreciated the scale and significance of what had happened to us.

However, things have regressed since his time.

Society has stopped recognising and documenting regression, choosing instead to incorporate the condition into the broader category of Autistic Spectrum Disorder (ASD). Since changes made to the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 2015 (producing DSM-5), ASD has included those with regressive and profound autism alongside much milder presentations and problems. The spectrum has become so wide that it is at the point of collapse.

If a child suffers regression it implies something has caused the decline. If a child has autism it tells us nothing about the history of onset, the severity of the symptoms nor the level of impairment. It is much easier to normalise autism than it is a catastrophic childhood regression.

Indeed, parents are told that autism was there from the start, that it is coded in the genes and is part of the normal diversity of human experience and capacity.

This broader diagnostic has been a disaster for us.

It allows clinicians to explain the problems away.

It allows our experience to be emasculated in neurodiversity-speak.

It facilitates the failure to research the causes of the collapse.

Worst of all, it enables the abandonment of children with profound health problems and disabilities.

All-inclusive autism provides the means to do nothing while telling us parents to put up and shut up.

Future generations will look askance at what has been done. They will wonder how it was possible for a society to ignore the obvious danger signals seen in our kids. They will express outrage that rising numbers of children could regress into life-long profound disability without anyone batting an eyelid.

There are some encouraging signs that others agree. A comprehensive paper published in 2023 highlighted the lack of agreed definitions of regression, the mixture of measures used to record change and poor cohort consistency across different studies. They also noted evidence of a link to a family history of immune problems that strongly speaks to our experience. They called for much more research and have established an international team to cooperate and collaborate in doing this work.

It is remarkable that 120 years after Heller was doing his studies and in the context of an exponential explosion of autism prevalence as well as the finding that as many as 30% of children with autism record some degree of regression, there is still next to no progress in identifying and addressing the cause.

A group of parents of affected children are in the process of launching a new charity to address this and people can sign up and find out more at this link: https://www.beyonddisintegration.com/

They are fighting against the tide of normalisation. They need our support.

Future generations depend on us changing the tide.

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In the three weeks since my last post, the news has only been bad.

First, we had the latest instalment in the long-running dataset collected from registers of school-aged children in Northern Ireland that showed yet another rise in the rate of those diagnosed with Autistic Spectrum Disorder (ASD). The rate is now 1 in every 16 children (or 6%) of those aged between 4 and 15, and the vast majority of these were reported to have special educational needs and/or disabilities (SEND).

Second, the latest data on the number of children with EHCPs were also released. Numbers increased to more than half a million (538,500) pupils (6% or 1 in 16) in England in January 2026. This was a rise of 11% on the previous year and represents a doubling in less than a decade. At least a third of these were awarded to children with autism.

Third, Alan Milburn released his interim report from an inquiry into the rising numbers of young people (aged 16 to 24) classified as NEET – Not in Education, Employment or Training. Remarkably, more than a million young people (1 in 8 or 12.5%) are now in this group; many of them have never had a job and most are not looking for one.

As the report explains, disability is a major part of the story: “In 2024 to 2025, nearly half of young people who are NEET in the UK, 45%, report having a disability - more than doubling from 21.1% in 2013 to 2014. Disability prevalence among all 16 to 24 year olds has also doubled, from 10% to 19.7% over the last 10 years.” Yet again, these figures suggest that 6% of the cohort have significant learning difficulties and/or disabilities that are holding them back.

Behavioural problems including neurodevelopmental disorders such as autism and Attention Deficit Hyperactivity Disorder (ADHD) are driving much of this rise.

To me, the only surprising thing is that people are not more surprised by these trends.

How can as many as 6% - 1 in 16 - school aged children have autism and/or special educational needs that require extra support? How can double this number – 1 in 8 – be unable to secure work or training to get into work? What does it mean for our future if these are the trends?

It used to be said that rates of autism were going up because people were ‘better at spotting it’ or ‘more aware than they were in the past’. This narrative implied an underdiagnosis of neurodevelopmental problems in previous generations and it drove a dash to identify the ‘missing adults’ that would be needed for this to be true. It is a fantasy that the Autism Tribune has covered before.

In contrast, it is now more likely that people will say that the rates are going up because of overdiagnosis and the medicalisation of behaviours that would previously have been understood as normal. The implication is that people are making things up.

This argument is being advanced by the Centre for Social Justice. They have just issued a report called Change the Prescription highlighting the unsustainable rise in SEND and associated benefit payments (Child Disability Living Allowance and Personal Independence Payment, Carers Allowance and Universal Credit) that now cost at least £24billion a year (equivalent to the combined wage bill of every teacher in a state school in England)(p.6).

Pursuing the argument that this MUST reflect overdiagnosis, the report draws on a survey of 1002 GPs (General Practitioners or family doctors) to explore their experiences of requests for assessment and diagnosis of autism and ADHD.

Researchers found that the vast majority (94%) had experienced a higher number of requests for assessment. Three-quarters (75%) agreed that the diagnostic boundaries have widened too much. Two-thirds (66%) believed that most of these patients were not suffering from autism or ADHD, even if they genuinely believed that they were.

In the past, GP referrals would have gone to specialist teams of NHS staff and involve in-person meetings and thorough assessment. However, ever-lengthening waiting lists have opened up a market for private providers who will complete an assessment online.

NHS patients now have the ‘Right to Choose’ (RtC) to pursue an assessment with one of these private providers and local Integrated Care Boards (ICBs) will usually cover the cost. Patients might be steered to specified providers with whom budgets have been agreed in advance, and there might be variable implications for follow on care (such as access to drugs in relation to ADHD), but it provides the means for a faster and easier diagnosis than one provided by NHS staff.

The scale of this private sector activity has escalated very sharply in just a few years.

Earlier this year, an independent researcher called Ronnie Cane submitted Freedom of Information (FOI) requests to all 42 Integrated Care Boards (ICBs) in England to ask about spending between 2023/4 and 2025/6. Three-quarters of respondents replied with data for at least one of these years and even with significant gaps in the data, the combined spending was £512.5 million. This spending had doubled each year.

Only four of the ICBs had any idea about how many assessments their spending had purchased and none had any idea about the outcomes from the money they spent.

In his report, Cane highlights the woeful lack of scrutiny and accountability over this spending and as he suggests:

“ICBs are commissioning hundreds of millions of pounds worth of neurodivergent assessments without measuring what that money buys. They receive invoices from private providers, they pay those invoices, and the numbers go up each year. Inputs are tracked. Outputs are not. Outcomes are invisible.”

As he later puts it, this is “not healthcare commissioning. It is invoice processing.”

Cane’s findings raise serious questions for the NHS and taxpayers, as well as the patients who secure a diagnosis that might be less than robust.

Given the length of waiting times for NHS services, it is not surprising that patients are requesting access to private providers – nor that ICBs are paying for the service because it reduces pressures on their waiting lists and ongoing complaints. However, it is remarkable that ICBs are handing over millions of pounds without adequate oversight of the services they are paying for, nor the outcomes for patients.

From: https://specialneedsresourcesdirectory.co.uk/

In the wild west of neurodiversity assessment, the leading providers share information about how to persuade your GP to make the referral. Many of them include a draft letter outlining why you should be referred including the relevant RtC legislation to back it all up. Once referred, almost all the assessments will be processed online and require written and verbal evidence of autism or ADHD. The websites of some of the larger providers make all this clear: Psychiatry UK, Clinical Partners Ltd, The Owl Centre, Psion.

The ‘evidence’ they suggest often includes a simple questionnaire designed in 2012 by Professor Sir Simon Baron-Cohen and colleagues from the University of Cambridge called the AQ10. This is recommended for use by adults who suspect they have autism and has been sanctioned by the National Institute for Care and Clinical Excellence (NICE) as part of the guidelines developed for adult assessment (CG142). Baron-Cohen was part of the expert panel involved in this work. It has been designed as a ‘gateway’ tool to identify potential autism and is widely used in primary care, hospitals, education, policing and probation.

In 2021, NICE reviewed its autism guidance and determined that the AQ-10 was still a useful screening tool stating that a referral for a comprehensive autism assessment should be offered to adults who score 6 or above on the AQ-10 and/or where autism is suspected based on a clinician’s judgment of a person’s experiences.

This must have opened the floodgates on poor beleaguered GPs.

Anyone who is relatively self-contained or introverted, good at focusing, poor at suffering fools and with a low tolerance for bullshit could find themselves fitting the bill (me included). There is no mention of impairment or disability, or the necessity of having problems in childhood. The survey highlights the kinds of autistic traits that are widely distributed across the population-at-large and it is remarkable that this is recommended by NICE.

You can try it out for yourself. You get one point if you agree to questions 1, 7, 8, 10 and the same if you disagree to questions 2, 3, 4, 5, 6, 9. Score more than 6 and you can request an assessment; it’s as simple as that.

The situation is a sorry old mess.

People who need assessment and diagnosis – and care - are stuck in long queues and the private sector is filling the gap.

However, this is happening without adequate oversight of the process nor the outcomes achieved.

There is an obvious risk that patients end up with an insecure diagnosis based on poor quality assessments with implications for the rest of their life.

Taxpayers are footing the bill with potential implications for health, education, welfare and social care costs.

Public patience for those labelled autistic is likely to wane.

Surely the answer is to secure NHS control of the waiting lists and to stratify access to assessment and diagnosis in relation to the needs of the patient? The youngest and most obviously disabled people should have fastest access while older and less impaired patients are more able to wait.

Precious funding should be used to provide the most rigorous route to assessment via the most cost-effective approach. This might include private sector providers doing some of the work, but it must include face-to-face assessment and confirmation of serious and enduring impairment. All clinical activity should be subject to rigorous standards of assessment and diagnostic discipline, with regular patient reviews to check that the diagnosis still stands.

If we had confidence in the diagnostic decision-making, then it would no longer be possible to dismiss the numbers as an artefact of either under or over-diagnosis; we would have to accept the numbers as real.

We might even start talking about what is causing autism and start doing something about it. I pray for that day to arrive.

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I think they need to adopt the label ‘profound autism’ [1] and tone down the neurodiversity speak - and here’s my pitch for this shift.

It’s drier and less personal than my usual posts but I wanted to share and get your ideas. I’m also promoting common cause with all the great work being done in America to do the same thing. The papers published for the first meeting of the Interagency Autism Coordinating Committee have been a fantastic resource. I salute the parents behind the new profound autism alliance and Jill Escher for her work in calling for change.

For more than 100 years, autism has been overseen by the disciplines of psychology and psychiatry. It is understood to be a developmental and behavioural disorder and is diagnosed accordingly. It used to be explained as a product of ‘refrigerator mothering’ and is now assumed to be a product of ‘genes’ or ‘genes and environment’.[2]

Over the past 30 years, a growing body of research has identified connections between autism and dysfunction in a range of biological systems including the microbiome, immunity, metabolism and energy processing with impacts on brain development and function.[3] This work has begun to address the aetiology of autism – and likely plural aetiologies underpinning different kinds of autism[4] – but it remains epistemologically siloed and has not yet reconfigured clinical practice and public policy.

At the same time, the psychological/behavioural perspective has proved vulnerable to (and is sometimes complicit with) epistemic capture by those declaring autism to be ‘difference not disability’. In just twenty years, the clarion call to recognise ‘neurodiversity’ has taken off across the globe. This has opened the door to the diagnosis of people with milder presentation. It has fuelled advocacy by those declaring themselves to be ‘neurodivergent’. It has also focused attention on acceptance and removing barriers to participation rather than efforts to address biological dysfunction and develop treatment. [5] Indeed, activists have campaigned against efforts to address the biological causes and consequences of the condition, actively shutting down the quest for treatment and prevention.[6]

People with profound autism have the same label but very different lives. They are usually unable to speak or communicate about their experiences and perspectives. They are fully dependent upon their parents, families and carers for support. Their experience is all-too-easily occluded by the more articulate, educated and independent spokespeople for the neurodiversity movement.

What’s more, living with profound autism is hard to bear. There is no public appetite to hear people talking about extreme constipation, incontinence, self-harm, seizures, insomnia, psychosis, agitation and anxiety. There is little public debate about the risks of danger and death from traffic accidents and drowning.[7] No-one hears about the people locked away in secure hospitals and residential establishments unless some abuse is exposed.[8]

There has been a dilution of what it means to be autistic and profound autism is largely ignored. We no longer have the language to talk about it, not least because so many people who suffer from the condition don’t have the ability to speak or communicate.

In addition, the parents of people with profound autism struggle with emotional, physical and financial burdens that all-too-often end in divorce and family breakdown. Parents often have no choice but to stop working to take on the fulltime care that is needed, for life. There is also a particular burden on siblings whose childhoods are affected by profound autism and the need to care once the parents have gone. These families are isolated from the wider community with no time or capacity to speak out about their experience.[9]

If autism is understood to be a matter of difference not disability, behaviour rather than biology, and gift over graft, it is much easier to look the other way.

Indeed, even health and care professionals seem confused about what is involved. Many parents report heart-breaking experiences of diagnostic overshadowing whereby the label ‘autism’ occludes recognition and treatment of health problems that would otherwise be addressed.[10] Gastrointestinal, immunological, metabolic and neurological problems (among others) are often ignored.[11] This diagnostic overshadowing and associated health injustice helps to explain the high numbers of premature and preventable deaths.[12]

Confusion about language has serious consequences for us all. Confusion about what we mean by autism has serious consequences for those with profound autism. It contributes to very significant health injustice. It has implications for securing access to appropriate services such as education and social care, as well as the benefit system. It has a very detrimental effect on families carrying the burden of care as well as the quality and length of life of people living with the condition.

The prevalence review provides an opportunity to:

• ·Recognise the people who have profound autism (representing about 25% of the overall group) and keep more accurate records.[13]

• ·Encourage government to adopt more resilient planning to meet the needs of this group in relation to education, social care and welfare support.[14]

• ·Highlight the injustice of diagnostic overshadowing and advise that clinicians routinely screen for and address the comorbidities that blight – and shorten - the lives of people with profound autism.[15]

• ·Open the epistemological window to find common ground with scientists exploring the aetiology of autism as well as related neurological and neurodegenerative disorders with a view to identifying potential biomarkers, treatments and prevention.[16]

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[1] Using the US IACC recommendation, profound autism is defined as 8 year olds with: “Minimal or no functional speech, defined as non-speaking; or limited to single words or 2–3 word phrases used primarily for basic needs, wants, or protests; and/or with limited ability to engage in flexible, reciprocal, or generative communication — meaning spontaneous, non-prompted, and contextually varied communication exchange; and a need for continuous or near-continuous supervision to ensure safety and substantial assistance with activities of daily living to meet basic needs.” Other definitions include Intellectual Disability (ID) and Learning Difficulty (LD), reflected in Intelligence Quotient (IQ), but the latter is rarely measured and impossible to determine with any accuracy when people can’t speak or communicate.

[2] Although this is just a social convention and is not reflected in medical practice. Indeed, there is no routine genomic screening done despite the fact that there are rare genetic variants that are associated with autism. Moss, J. and Howlin, P., 2009. Autism spectrum disorders in genetic syndromes: implications for diagnosis, intervention and understanding the wider autism spectrum disorder population. Journal of Intellectual Disability Research, 53(10), pp.852-873.

[3] McElhanon BO et al. 2014. Gastrointestinal symptoms in autism spectrum disorder: a meta-analysis. Pediatrics.133(5):872–883; Liu X. et al. 2022. Prevalence of epilepsy in autism spectrum disorders: a systematic review and meta-analysis. Autism. 26(1):33–50; Frye RE. 2020. Mitochondrial dysfunction in autism spectrum disorder: unique abnormalities and targeted treatments. Semin Pediatr Neurol. 35:100829; Heuer L et al. 2008. Reduced levels of immunoglobulin in children with autism correlates with behavioral symptoms. Autism Res.1(5):275–283.

[4] Whiteley P et al. 2025 From autism to the plural ‘autisms’: evidence from differing aetiologies, developmental trajectories and symptom intensity combinations. Br J Psychiatry. Jul;227(1):492-498; Lombardo, M.V. and Mandelli, V., 2022. Rethinking our concepts and assumptions about autism. Frontiers in Psychiatry, 13, p.903489.

[5] This social movement has had deleterious impacts on policy development and service planning such that the House of Lords inquiry into the Autism Act (2009, 24) declared that “Autism is not an illness … [and] is not a learning disability … [and] is not a mental health condition … [and is associated] with other forms of neurodivergence”. Which rather begs the question of why it is seen as a problem, and certainly why it is diagnosed by doctors!

[6] Spectrum 10K - Wikipedia; Spectrum 10K (updated 31.01.25)

[7] Xie K. et al. 2025 Unintentional Drowning Incidents Involving Children with Autism Spectrum Disorder Treated in US Emergency Departments, 2016-2020. J Autism Dev Disord. 27:10.

[8] https://www.mencap.org.uk/get-involved/campaign-mencap/transforming-care-homes-not-hospitals

[9] Bloch, J.S. and Weinstein, J.D. 2009. Families of young children with autism. Social Work in Mental Health, 8(1), pp.23-40; Gorlin, J.B et al. 2016. Severe childhood autism: The family lived experience. Journal of pediatric nursing, 31(6), pp.580-597; Baker, P et al. 2021. A survey of complex trauma in families who have children and adults who have a learning disability and/or autism. Advances in Mental Health and Intellectual Disabilities, 15(5), pp.222-239; Rochefort, C et al. 2023. Siblings of individuals with intellectual disabilities or autism: A scoping review using Trauma Theory. Journal of Child and Family Studies, 32(11), pp.3482-3500.

[10] Wills, J. and Evans, Y., 2016. Health and service provision for people with Autism Spectrum Disorder. Thinking Autism.

[11]Khachadourian, V. et al. 2023. Comorbidities in autism spectrum disorder and their etiologies. Translational psychiatry, 13(1), 71; Hyman SL et al. 2020 Identification, evaluation, and management of children with autism spectrum disorder. Pediatrics.145(1):e20193447; Hirota T and King BH. 2023. Autism spectrum disorder: a review. JAMA 329(2):157–168.

[12] Catala-Lopez, F. et al. 2022. Mortality in persons with autism spectrum disorder or attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. JAMA pediatrics, 176(4), p.e216401. Learning from lives and deaths of people with a learning disability and autistic people (LeDeR) review.

[13] Profound autism: a medical view; Wachtel, L.E et al. 2024. Profound autism: An imperative diagnosis. Pediatric Clinics, 71(2), pp.301-313. Hughes, M.M et al. 2023. The prevalence and characteristics of children with profound autism, 15 sites, United States, 2000-2016. Public Health Reports, 138(6), pp.971-980.

[14] Lord, C et al. 2022. The Lancet Commission on the future of care and clinical research in autism. The Lancet, 399(10321), pp.271-334.

[15] It is interesting that local authorities have published on this and the health service has been slow to catch up. See also Shaw, S.C et al. 2024. Barriers to healthcare and a ‘triple empathy problem’ may lead to adverse outcomes for autistic adults: A qualitative study. Autism, 28(7), pp.1746-1757.

[16] https://child-neurology.org/news/autism/converging-pathways-the-emerging-biological-links-between-autism-spectrum-disorder-and-alzheimers-disease/

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Clements is also the father of a son with autism, Attention Deficit Hyperactivity Disorder (ADHD) and Pathological Demand Avoidance (PDA). He has battled to get educational support for his son, and he knows the system isn’t working for children like his, who need it the most.

However, he also smells a rat. His progressive commitments are being stretched to their limit, and as he declares towards the end of the book: “the urge to disengage our critical faculties because we consider ourselves progressive, or don’t want to appear unkind, isn’t going to solve the problem” (p.111). Amen to that!

Clements recognises the genuine challenges facing schools as they try to educate increasing numbers of children with learning disabilities and behavioural problems. He has been a parent-governor at a primary school. He has seen the data on the rising numbers of children with Education Care and Health Plans (EHCPs), he knows about the scary numbers of children being suspended and excluded from school, as well as the shocking numbers who never show up. He knows that inclusion is causing much pain and no gain. Indeed, he puts it brilliantly when he says:

“We are throwing vast sums of money at an ill-defined problem, or set of problems, faced by a rapidly growing minority of our children. And we are doing it without any evidence that is making any difference” (p.83).

Clements rightly challenges the paperwork involved in EHCPs and the need for reform, pointing out that “the whole exercise becomes a bureaucratic means to a financial end, rather than a deficit to be addressed” (p.84). Once you have the EHCP you rarely get the solutions you crave. We need something better. Much better in fact.

However, Clements also follows his nose for that rat. He wonders out loud if people are making it up. He exposes the neuro-narcissists who try to revive their flagging careers by coming out as autistic or having ADHD. He is rightly cynical about celebrities declaring themselves to be autistic when challenged about poor behaviour. He knows there is something wrong with a society that uses labels to explain away any embarrassment or difficulty.

Thus, Clements links the special needs crisis to wider cultural changes that help to explain the explosion of ‘need’. He highlights the dangers of a therapeutic culture that encourages people to dwell on their psychological challenges and to talk (endlessly) about their mental health. He recognises that the language of neurodiversity “is as much a culture war on reserve, resilience and restraint as it is a discussion about the peculiar psychological dispositions associated with autism” (p. 61).

Indeed, he documents how neuro-talk reinforces the ongoing effects of family breakdown, absent fathers, lack of discipline and increased welfare dependency. Children are encouraged to feel weak and defeated – to be ‘needy’. And what’s more, those in charge do the same. Clements rightly calls out the politicians and teachers who deserted their posts and embraced school closures and mask wearing during the madness of the pandemic.

In the scariest and most powerful part of the book (Chapter 5), Clements argues that this emergent therapeutic culture is now shaping all mainstream schools. He contends that the movement to promote neurodiversity is a trojan horse that is helping to erode behavioural and educational standards and expectations in schools. He reports on an intervention called Mentally Healthy Schools that aims to “embed the ideology of neurodiversity in schools” so that: “Every classroom is neurodiverse. Each pupil will have a different way of thinking, feeling and learning. This should be encouraged and supported” (p.129).

Similarly, the Department of Education’s Partnership for Inclusion of Neurodiversity in Schools or PINS is all about mainstreaming support for children with neurodevelopmental disorders. Teachers are encouraged to think about sensory-friendly classrooms, to install movement breaks, to provide individualised learning plans and divergent expectations. While this used to be done for the minority of children with an EHCP, it is now being rolled out for everyone – including all ‘neurotypes’ (p.131).

Clements rightly points out that schools already have an inclusion problem whereby children with serious learning and behavioural disorders are included in mainstream schools, disrupting educational outcomes for themselves and their peers. Yet the direction of travel is to support MORE inclusion, to further reduce access to specialist provision and to turn every school into a special needs school. Neuro-mainstreaming is the ultimate goal.

For Clements, this is a bad way to go, and as he suggests:

“Education shouldn’t be reorganised around what are … a small minority of pupils who may be better served in specialist schools or other settings. Trying to create ASD-friendly schools, when only a fraction of children are diagnosed with it, seems just a little disproportionate, even to this parent of an autistic child.” (p. 135)

Reorganising the culture of the school in line with ‘neurodiversity’ is akin to previous efforts around anti-racism, de-colonialism, pro-transgenderism or anti-masculinity. The political preoccupations of adults – and a small minority of adults at that – are being smuggled into the classroom with devastating implications for the children involved.

Clements is right to argue that “there is something corrosive about the creation of a special needs culture. If some children are allowed certain privileges or can gain concessions not available to other children, however justifiable they may or may not be, it can foster resentment in their peers” (p.146).

It is likely that the classroom collective will turn on the children who are allowed out to play, or given extra time in exams, if everyone thinks they are making it up. However, while the children will call it out, the teachers are obviously very afraid (and Clements reports on a number of furtive conversations with those who have concerns but can’t speak out in the staffroom).

In his final chapter, Clements asserts that ‘we can’t go on like this’. He knows that the special needs crisis is “as much a social and cultural phenomenon as it is a clinical or educational one” (p. 150), but he doesn’t really know what to do.

He rightly wants to separate genuine needs (the ‘deserving disabled’) from those who have other reasons for attaching themselves to the group - what might be called the ‘undeserving diagnostic disaster.’ He rightly calls for more specialist provision to be built for those with very high needs. He also wants a simpler system for identifying needs and having them met.

However, he also wants the adults to man-up and start taking charge. Parents need to foster a culture of self-discipline, hard work and delayed gratification. Clinicians need to exercise restraint in giving out labels that make people weak. Educational institutions need to focus on the core business of education (what an idea!)

Readers of the Autism Tribune will not be surprised to hear me say that we also need to understand what is causing autism and related neurological disorders in our young people. The numbers might be relatively small, but they are rising fast, and the research points to underlying biological dysfunction in brain development associated with immunity, gut and metabolism.

It is here that Clements has yet to fully break out of the progressive cage of his past. He dismisses those who are trying to take a biological view in just a couple of pages. He has no time for the argument that pharmaceutical drugs or vaccines might be causing the problems. He repeats the usual mantra about Andrew Wakefield and the link to the MMR being ‘debunked’ (p.33 and 76) but he thereby bins the insight that will eventually get us out of the mess.

It is only when we take a clear-eyed view of what is wrong with our children that we will be able to adequately address what is shaping up to be the existential threat of our age. Even if you don’t want to sign up to the Wakefield view of the world (which despite the attacks is rather mild and polite), we need to do the kind of research he was doing so well. In my book, autism is a manifestation of inter-generational damage to the human immune system, and the prognosis is not looking good.

In his book, Clements rightly says that too many children today are “distressed, disabled, disordered and disengaged” (p.165). If we don’t change course, this will only get worse. The changes are manifest in our children’s health as well as the wider culture - and both are increasingly sick.

Clements has done a great job in asking important questions about what has gone wrong; we now need to focus our energies on finding some answers.

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What used to be diagnosed in shabby rooms at the back end of the psychiatric estate has become a must-have label that is open to all - and it can be yours if you go online, complete the survey and pay a large fee.

What used to be understood as a rare and crippling, life-long, neurodevelopmental disability has become a disorder you can adopt with great pride.

What used to be hidden away in psychiatric hospitals, special schools and residential homes is now out in the open; except that it isn’t.

Only one version of autism has become fashionable: The mild version that doesn’t require institutional restraint, specialist support and full-time care. The version that makes good TV, adds colour to the lives of fading celebrities and fuels the intellectual life of our universities.

This is the acceptable kind of autism, the one that is ‘difference not disability’. The one that is about ‘neurodiversity’ not neuro-dysfunction.

This happy-clappy autism has almost entirely obscured the less-happy kind.

You wouldn’t know it from the public debate, but growing numbers of children have the kind of autism that requires a special school place.

Local authorities have had to expand their own special schools and fund placements at private schools to accommodate this demand.

This week, I decided to look at what has been happening in the place where I live – Cornwall – a beautiful rural county (and some would say an ancient nation) in the far southwest of the UK.

As summarised in the table posted below, since the 1970s, the small estate of council-owned schools has grown into a special academy trust that has just built two new schools – bringing the total number to six.

The council has also supported placements at four new private special schools.

They also pay for placements in alternative provision at five local sites, as well as hospital-based education for a small number of permanent pupils as well as a larger group who have short term support in three different sites.

Over recent years, the council has supported the establishment of specialist bases within mainstream schools and there are more than twenty of these.

A growing number of children are registered as being in what’s called Education Otherwise Than At School (EOTAS), some of which is also paid for by the council covering up to 25 contact hours (for a pre-16) and 18 hours for post 16 a week during term time (38 weeks a year). Examples include online schooling; tuition at home; tuition or training at a specialist centre; life skills training; mentoring and therapeutic intervention. The most recent data (published following a FOI request in 2023) indicates that 54 children were supported for EOTAS, but this group is known to be rising in size.

Although we know that small numbers of children – likely those with the highest levels of needs - are sent to specialist residential provision outside Cornwall, there are no published data on the numbers involved.

Each of these children clearly has very high levels of need. Many of them have severe autism.

They represent just over 2% of all the pupils in Cornwall.

Contrary to what I might have expected, our rural and peripheral county is very much in line with trends across the rest of the country.

These children deserve much greater attention and all the talk about neurodiversity does them no favours at all.

While the number of children with special educational needs has risen fast (to 1 in 5), those with greater needs, supported with Education, Health and Care Plans (EHCPs), has now reached 1 in 20. My research indicates that the number in specialist provision has now reached 1 in 50.

No one talks about this latter group whose needs are immense.

I wish that politicians, researchers, clinicians, high-profile influencers and policy makers would visit a special school before they unthinkingly adopt the language of neurodiversity. It is not helping our children and young people to make sense of the world, and it is certainly not helping those most in need of support.

Special schools in Cornwall – a chronological view

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We live in a world in which everyone has a diagnosis for something.

There is an alphabet soup of neurological disorders from ASD (autism) to ADHD (Attention Deficit Hyperactivity Disorder) to DCD (Developmental Coordination Disorder which used to be Dyspraxia) to PDA (pathological demand avoidance) – and likely many more.

The same is true for emotional disorders: Major Depressive Disorder (MDD), Persistent Depressive Disorder (Dysthymia), Bipolar Disorder, Obsessive Compulsive Disorder (OCD) and Borderline Personality Disorder (BPD).

Another group comprise a mix of the two: Myalgia Encephalomyelitis (ME), Chronic Fatigue Syndrome (CFS), Ehlers Danlos Syndrome, Mast Cell Activation Syndrome (MCAS) and Postural Orthostatic Tachycardia Syndrome (POTS).

Another year, and likely another category of neurological and emotional dysfunction will emerge.

When reports are published documenting the shocking numbers of children and young adults who are given these labels, older people will surely shake their heads.

They’ll tell us: “It wasn’t like this in my day”. “These youngsters are snowflakes who don’t want to do anything”. “The benefit system stops people taking care of themselves”.

I get it, I really do.

I’m relatively old and it wasn’t like this in my day either. When I went to school no-one had autism, none of their relatives had autism and no-one in my local community had autism.

Even twenty years ago, it wasn’t like this.

When our son was diagnosed with severe autism in 2008, we didn’t know anything about it. No one in our family had anything like it. The teachers at the local primary school hadn’t seen more than a few cases and the local authority could just about manage demand.

The problem felt rare.

Just twenty years later, this is no longer the case.

Every family, school and community is touched by the range of neurological and emotional problems outlined above. People are in denial and reach for simple explanations to make sense of it all. It’s all too easy to blame the ‘bad behaviour’ on poor parenting, social media and the benefit system but at the same time, it’s impossible to ignore the scale of the problem.

As a result, we suffer from janus-headed reporting and debate.

On the one hand, we read heart-breaking stories about families struggling for a diagnosis and additional help. Schools report being overwhelmed with the numbers of children with special needs they are expected to handle. Our councils are going bankrupt trying to provide places in special schools, taxis to get there and social care when the children grow up.

On the other hand, we are repeatedly told that the numbers just can’t be real. Common sense tells us that it MUST be overdiagnosis or mass hysteria or benefit fraud. Even the government’s independent review on the prevalence of mental health disorders, ADHD and autism just published an interim report that has fuelled another round of confusion and a rush of denial.

It’s not surprising that people are well and truly befuddled: Are the numbers real or are they made up?

Sadly, personal experience tells me that the numbers are real. Our precious son regressed into autism about 20 years ago when it was still very rare.

Ever since, I’ve tried to understand why.

My Mum and Dad married just after the end of the second world war.

They were the generation encouraged to use formula milk, to keep up to date with vaccinations and to administer antibiotics whenever required. I was born into a bright new world of great (and false) hope.

I ended up with chronic eczema, asthma and hay fever. I had bronchitis every winter and even had a bout of pneumonia before reaching secondary school. I had antibiotics at least once a year.

This legacy was passed to my children and they suffered worse. Despite vaginal births and being exclusively breast-fed, both have ongoing immune problems.

Our daughter was born with eczema. She has histamine intolerance and mast cell activation that can cause chronic headaches, nose bleeds, rashes, eczema and cystitis. Our son regressed into eczema, chronic constipation and neurological damage and was diagnosed with severe autism before he was 5.

When our daughter (now 27) has children, the challenges will likely be further increased unless something very drastic is done and even then, it might be too late.

New research makes a direct link between the kinds of allergies that have afflicted two generations of my family and the gut microbiome you inherit at birth. If your mother has a weak microbiome due to regular antibiotic use and/or you are born by caesarean section and/or not breast-fed, you are much more likely to have the kinds of immune and neurological dysregulation that is now evident in the population at large.

It sounds far-fetched, but the alphabet soup of disorders now afflicting our children and young people might well be related to the micro-organisms that live in their gut, and the ones they inherit from their mothers in the first minutes of life are the most important of all.

Healthy babies are born with a preponderance of bifidobacterium in their gut (species B. longum subsp. infantis, B. breve, and B. bifidum) and these are known to prime the immature immune system to recognise pathogens and mount an effective response. Without these, human infants are much more likely to develop allergic and inflammatory disease – as has happened to me and my kids.

A research project called My Baby Biome has just reported that as many as a quarter of the 400 American infants included in their study had no detectable Bifidobacterium in their microbiome. This rate went up to 35% of those delivered via caesarean section but also included 19% of those born vaginally. In addition, breast feeding was not enough to restore the ecological gap in these groups (as was likely the case for my kids).

When revisited two years later, the children who lacked good levels of Bifidobacteria in infancy were much more likely to have developed allergic disease or atopy (eczema, asthma, hay fever, anaphylaxis and/or food allergy). The researchers also identified key metabolites normally produced by Bifidobacterium that were then disrupted in these kids including the Short-Chain Fatty Acids acetate and lactate, and the aromatic lactic acids Indole‑3‑lactic acid (ILA), Phenyllactic acid (PLA) and 4‑hydroxyphenyllactic acid (OH‑PLA). This has a direct impact on their developing immune system and resulting inflammation as well as weakening the wall of the gut.

Potentially pathogenic organisms such as Clostridium perfringens were found in the guts of these children. These organisms can consume human milk and formula sugars, but they further increase the risk of inflammation and other disease.

The research thus suggests that more than a quarter of American infants are now born with a vulnerability to disease and disability that is likely life-long and this helps to explain the surge in neurological and emotional problems now afflicting our youth.

My formula-fed and antibiotic-depleted microbiome was passed on to my children leaving them vulnerable to inflammation, allergic disease and neurological damage. Unable to mount a proper response to the diseases they subsequently encountered (via contact or needles), their inflammation only went up.

We are now grappling with mounting evidence of the perfect storm cooked up by the post-war mission for ‘good’ public health. Low rates of breastfeeding, high rates of caesarean section, regular use of antibiotics (often during the process of birth itself), growing numbers of vaccinations and the widespread use of pesticides and herbicides all cause further damage to the microbiome.

The prognosis for the UK is not looking good:

Rates of caesarean section have risen from just 2 or 3% in the 1950s to almost half of all births.

Rates of exclusive breastfeeding for at least 4 months fell from about a quarter in the 1950s to a low point of just 3% in the 1970s before rising to less than 12% now.

While antibiotics were used sparingly and mainly for severe infections in the 1950s, a substantial proportion of women of child‑bearing age now receive one or more courses of antibiotics in their adult life. Many are given antibiotics during delivery and regular use causes a dramatic depletion in the quality of the microbiome passed on to newborns.

There has also been a rise in the number of diseases for which vaccinations are given, rising from 4 or 5 in the 1950s to up to 18 diseases today. In addition, greater numbers of polyvalent vaccines (such as DTP and MMRV) are administered which are particularly challenging to a weakened or disrupted immune system.

On top of this, there has been an explosion in the manufacture and use of pesticides and herbicides since the 1950s, altering human exposure to micro-organisms in our food and environment.

Changes in methods of delivery, feeding protocols, vaccination schedules, and the use of antimicrobials in medicine and food production, have created a perfect storm for our health. My experience points to the likely catastrophe that is coming our way.

If growing numbers of babies are born without the microbiological ecosystem that they need to survive and thrive in our world, the rising incidence of disorders is a very tragic result.

While we won the war, we have tragically lost the battle for the health of the next generation. Something needs to be done.

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Yesterday’s media outlets were awash with stories about autism being over-diagnosed in the quest for benefits and extra time in exams. Written in response to the ill-timed (but presumably, government sanctioned) release of an interim report from the Independent Review into mental health conditions, ADHD and autism, journalists were able to pick up on the narrative of over-diagnosis all over again.

We’ve heard all this before, and I’ve written about it before: autism has become a political football kicked around for good sport.

We are constantly told that the number of children with autism isn’t really going up – it is all about better awareness, wider criteria and greater inclusion.

Except that when you look at the data that capture what is going on – as I did last week – and find that the numbers of those with the greatest levels of need have doubled in less than a decade.

Except that when you look at the pressure on the local authorities that pay for these children to get an education, you find they are all going bust.

Except when you talk to parents at the school gate and community centre, all of whom know families struggling to support children with severe autism who often wait years to get a diagnosis and extra support.

Except when you think about your own family and recognise the growing incidence of autism, behavioural and learning difficulties that are blighting our kids.

Despite all the noise about diagnosis, we know something very serious is going on. Sooner or later, people will have to wake up.

In the meantime, Easter is a time to reflect on the light and dark in the world.

We celebrate the triumph of love over the denial and denigration of all that is good.

Autism has given us a deeper appreciation of the power of unconditional love, and the importance of family and community. Despite the challenges in getting out of the house, we have made relationships with other parents who are looking for answers about how to help their children.

The charity Thinking Autism provided a lifeline to us when we sought to improve the health of our son. We learned about the emerging research that helps to explain why our children suffer from so many health problems despite the potential for treatment. This has made a dramatic difference to our lives ever since.

For me, autism has always fuelled hope for the future.

First, to find ways to support our son to be the person God planned him to be. I’m late to the party, but I’ve just read the amazing story about Jamie Handley learning to spell. I’d urge all parents of children with severe autism to read it and have your mind truly blown. It reminds me why we never ever give up (and I’ll come back to this in much more detail in a post very soon).

Second, there is still hope for the next generation. Our species has been remarkably successful because we are able to recognise what has gone wrong and do something about it. We can never give up hope that this doesn’t happen too late.

The Autism Tribune was launched with the strapline: Freeing the next generation from neurological harm.

When the numbers of children affected continues to rise – in all corners of the globe - and when denial seems stronger than ever, us parents have to keep battling for the truth. Our children and our children’s children depend on it.

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Charities across the world are gearing up to celebrate the neurological disability that we call autism.

Last year, I suggested that we call it Angry about Autism month.

This year, there is even more to be angry about.

The Labour Government is trying to reduce the fiscal burden of autism by reviewing entitlements to welfare payments.

They are also consulting on proposed changes to the system of support for Special Educational Needs (SEN) that will reduce the number of Education Health and Care Plans (EHCPs) and thereby remove access to the legal process to appeal a decision. The goals are to keep more disabled children in mainstream schools, to reduce access to specialist schools and to bring down the cost.

Just this week, local authorities were told that the debts they have already accrued in supporting high-needs children (which will bankrupt 8 in 10 local authorities if nothing is done) will only be paid if they commit to NOT building any new special schools.

At the same time, ministers are gunning for the private sector schools that have mopped up gaps in provision with plans to restrict the fees that are paid.

This will create a hurricane on top of an ongoing storm: rising numbers of children needing greater levels of support in the context of reduced specialist provision which means there is nowhere to put them when things go wrong, as they will.

Airy-fairy talk about ‘inclusion bases’ and ‘experts on hand’ won’t convince any parent who has experienced the system as it currently stands. The reforms will mean mainstream schools and teachers struggling to support children with very complex needs, with more of those children being excluded, with parents having to stop work to look after their children, and with other pupils suffering too.

Our son was diagnosed with severe autism in 2008. Once we got a statement that later became an EHCP, we asked the local authority for a special school place. There was no such place. Even then, the council provision was full.

By the time he was heading for his final year in primary school, he had made such little progress and was so limited in his ability to access mainstream provision, that we had to rethink. A charity told us that the best option was to find a private school that had a space and then threaten the council with a tribunal if they wouldn’t agree to pay for the place. We did this and they backed down. He then had to travel for up to two hours a day in a taxi with an escort to get to the school. It must have been very expensive indeed.

Just a year later, when he turned 11, he was able to transfer to a council-run special secondary school and was taken on a school bus. The cost was much less.

The government’s SEND reforms make sense ONLY if the number of children like our son is not going up.

However, there is no evidence that this is the case. Indeed, the Government has just launched yet another review to find out more about the prevalence – and trajectory - of autism, ADHD and mental health concerns because the numbers only ever go up.

We find ourselves in Autism Acceptance month with our government outlining major cuts in education provision and associated welfare benefits for those with learning difficulties and disabilities, chief of which is autism. At the same time, they are asking a panel of experts what they think about the conditions that are driving demand. It is hardly joined up and makes suspicious people (like me) think that the review is designed to endorse the reform.

For my contribution to Angry about Autism month, I have tried to get to grips with the official data to see what they show.

It turns out there are two different sources of data on SEND.

The first comes from a census of schools so it excludes children who are not in school due to exclusion or home-schooling, or who are in preschool, FE college or not in employment, education or training (NEET). The latest data tell us that in January 2025:

Over 1.7 million pupils in England had identified special educational needs, an increase of 93,700 pupils over the year (or 5.6% on the year).

This is a rate of about 1 in 5.

Of these, 482,640 (about a third of the total) had a level of need sufficiently serious to secure an EHCP, a number that increased by 11% on the previous year.

This represents about 1 in 20 (or 5%) of all pupils.

About a third of these pupils (149,217) were autistic with a sufficient degree of learning disability to qualify for an EHCP.

Half of all the pupils with an EHCP (including 50% of those with autism) were sufficiently disabled to be placed in specialist schools; 4000 in charity-run state-approved schools; another 4000 in pupil referral units; 40,000 in private provision with government funding; with the remaining 160,000 in state special schools.

The second source of data comes direct from local authorities, documenting requests for EHCPs, assessments, decisions and overall numbers. These figures include everyone with an EHCP even if they are not covered in the school census data outlined above.

The latest figures for January 2025 report that:

638,700 children and young people had an EHCP, an increase of 10.8% over the previous year.

These data were swelled by 7,000 young people who were educated at home and who were part of a larger group of ‘other provision’ that catered for as many as 50,000 young people; another 88,000 who were in further education provision; and 18,000 who were doing nothing at all (not in employment, education or training (NEET)). Rather alarmingly, there were another 19,000 whose placement was not recorded at all.

Children and young people are only awarded an EHCP if there are serious and incontestable grounds for concern. The official data tell us that only 65% of the cases requested are assessed, and of these, as many as 94% are awarded, indicating a robust case has been made.

Schools and parents must provide evidence of:

• A learning difficulty or disability requiring special educational provision, encompassing communication, cognition, social/emotional, or physical needs.

• A level of need that is severe or complex enough that it cannot be met through standard SEN support (e.g., school-funded SEN support).

• Evidence that despite increased, targeted support (often school-based SEN support), the child is not making adequate progress.

• Professional reports (educational psychologists, therapists), school reports, and diagnosis letters demonstrating the necessity of this extra support.

You can’t make all this up.

We should be jumping up and down with alarm as more than 600,000 children and young people (aged 0 to 25) have a learning difficulty or disability sufficient to warrant an EHCP.

Both datasets indicate that about a third of the children and young people with an EHCP have autism, another 20% have speech, language and communication difficulties, and another 20% have social emotional and mental health problems. Many of these overlap.

Both datasets indicate that there has been a steady increase in the numbers and rate of EHCPs since 2018.[i]

While there were 73,450 pupils with an EHCP due to autism in 2018, by 2025, this had risen to 149,217 with another 114,772 pupils identified as autistic without an EHCP.

In 2025, schools were educating more than quarter of a million pupils (263,989) with autism, and about a third of them were in special schools.

These data tell us there was a doubling of the number of pupils with autism of a severity requiring an EHCP in less than 10 years.

There were 75,767 more pupils with autism sufficient to secure an EHCP; a rise of about 10,000 a year from 2018.

These pupils would fill 75 averagely sized secondary schools in less than a decade.

Another 75 thousand children and families are dealing with autism – on top of the 110,000 who have autism without the learning difficulties required for an EHCP.

This represents future demand for services, often for life.

You can’t get an EHCP without evidence of learning difficulties, complex needs and a failure to progress; something very serious is going on.

We should never accept or celebrate the neurological damage that is being inflicted on ever increasing numbers of our children and young people. It is a monumental disaster and looks set to get worse.

Trying to make the unacceptable acceptable in Autism Acceptance Month is a clear indication we are losing our minds.

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[i] It is important to note that prior to 2016, the number of students with a statement of SEND was stable at approximately 230,000 a year.

Table for SEND support in England, 2006 to 2010

The numbers of pupils with statements for autism was also stable, as can be seen.

In 2010, there were 39,320 pupils in state schools of all kinds who had a statement for autism (like our son). There were a further 16,930 given extra support in a programme called ‘school action plus’ due to their autism (56,260 in total). There were likely some additional students educated in other provision including charity provided state-approved schools who don’t show up in these figures (in Table 11).

As we have seen, this has changed dramatically.

The equivalent numbers in 2025 were149,217 (with an EHCP) with another 114,772 (without an EHCP), comprising a total of 263,989, and all of them will have additional needs.

Despite the challenges in data collection, the evidence is very clear: the number of children with autism has risen exponentially, it should be cause for alarm.

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Last weekend, Frith hit the headlines after declaring that the notion of autism being a spectrum has been stretched so far it has come to to the point of collapse.

Despite previously supporting the incorporation of classical autism with much higher functioning cases, she has now thrown the notion of the spectrum under the bus.

Frith is understandably upset about the way that autism has become a celebrity-endorsed label that is liberally applied to all sorts of people and activities with little-if-any grounding in clinical practice. She is cross that the diagnostic clarity about autism has been overshadowed by the inclusive notion of ‘neurodiversity’ which necessarily includes everyone and makes “medical diagnosis completely meaningless”. She wants to rescue our children – who have very serious disabilities that will likely be with them for the rest of their lives – from celebrity attention seekers who use the label to cover their sins.*

So far, so good, you might think. She is way ahead of some of her students who have willingly undermined their own profession and professionalism by labelling everyone as ‘neurodiverse’.

However, there is something much bigger at stake in the comments she makes. She opens the door to a paradigm shift.

Since its inception, autism has been diagnosed on the basis of behaviour. It is associated with deficits in social interaction and communication, restricted interests and a desire for sameness.

There has never been any adequate explanation for these behaviours.

In the past, the problem was laid at the door of ‘refrigerator Mothers’. Today, we are told it is ‘genes and environment’. But the clinicians are telling stories. None of them knows.

And it is here that Frith gets most interesting. She acknowledges that “there is a lot more work to be done.” She calls for ‘biomarkers’ that alert us to the biological pathology that explains the problematic behaviour. As she puts it: “We do not have a biomarker, and I suspect that when we get a biomarker, we will need more than one. There will be different kinds of autism – many different kinds.”

Frith is making the case for psychologists to start working with biologists. She is opening the door to a paradigm shift that should have happened decades ago.

In fact, there is already a wealth of rigorous research that points to the biological pathologies that explain autistic behaviour.

I’ve had a go at listing these and associated biomarkers in the table below.

Biological explanations for autistic behaviours with potential biomarkers and treatments

The well-established causal impact of particular (rare) genetic variants (included in the final row of the table) highlights the biological pathways that are already implicated in the condition. In addition, it is obvious that these biological pathways overlap such that having deficits in an area like immunity will impact on both bowel and brain. If screening was routine, it would be possible to identify clusters of cases that are amenable to treatment. There are also be important overlaps with other neuropsychiatric, neurodegenerative and metabolic conditions that provide pointers to diagnostic tools and potential treatments. [This table needs more work so please send edits and additions and I can update and reshare]

For more than 100 years, the psychology profession has had a stranglehold on research and clinical practice in autism. One of their most established and successful academics has now admitted that they made a mistake.

The time has come for an alternative paradigm. We need full spectrum science to understand the full spectrum of symptoms that we currently call ‘autism’. It is likely that different and/or overlapping pathologies underpin different manifestations of the condition (early onset, regressive, anxiety-related etc) with important connections to the patterns of comorbidities that accompany these (such as bowel problems, allergies, insomnia and OCD). If we can understand what has gone wrong, we can identify how to treat it and how to stop it happening in the first place.

It is (more than) annoying that we have had to wait for Dame Uta to come to the end of her career for a flash of insight like this. For decades, us parents have been hitting our heads against the wall of the psychological paradigm, trying to get our children some medical help. There is still no routine screening for the genetic, energetic, immune and metabolic disorders that are clearly plaguing our kids. Indeed, clinicians are advised - by psychologists - NOT to look at such things.

We have to hope that Dame Uta’s intervention provokes the paradigm shift that we all badly need.

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*Although I haven’t made anything of it, Dame Uta seems to think that the number of children with classical autism at the severe end of the spectrum has remained largely stable over time. This is sadly not true. The rising demand for EHCPs, places in special schools and disability payments has been driven by diagnoses of severe autism. These comments reflect the paucity of any decent data on autism rates and severity in the UK. Given the social and economic costs of autism, and the need to plan services into the future, this is truly remarkable and I’ve commented on it before.

In the build up to Easter, Christians reflect on the inevitable imperfections of our species. It is a time to come to terms with our collective failings, and to prepare for them in advance. We know that human beings are easily seduced by easy answers and easy money. It is all too easy to do the wrong thing. Humility is the only response.

Yet humility has never been less popular than it is today.

Our public life is dominated by politicians and corporations who promise the earth.

It’s not popular to stand up and say there are no easy answers to the problems we face.

Indeed, when the problems become more intractable, the puffed up promises of progress resonate more.

We know that health outcomes are falling even as spending goes up. We know that more people are homeless even though we build increasing numbers of homes. We know that more of our children have learning difficulties despite spending more than ever on education support.

Despite this, our public figures are addicted to proffering hope.

Imagine standing up and admitting you don’t have a clue.

Imagine telling the public that you know it’s a mess and will only get worse.

Imagine advising that hard choices must be made (and losing the vote!)

Progressivism fuels cynicism and we are living with an abundance of both.

Here’s a step-by-step guide to the progressive playbook with an example of what can go wrong.

Progressive step 1: Eliminate all disease and the associated inconvenience of illness. Ensure everyone gets a standard dose of immunity delivered via vaccines that are logged in a little red book.

Progressive step 2: Deny any negative side effects. Overlook the benefits of testing and strengthening natural immunity by fighting disease. Overlook the extent to which human diversity manifests in response to the jabs. Silence anyone in authority who points all this out.

Progressive step 3: Ignore the rise in immune-related ill health. Call it idiopathic or genetic or a lifestyle decision. Support the sick with benefits and services that keep them alive. Ignore all the science that points to the role of a faltering immune system and the link to ill-health.

Progressive step 4: Stick to the plan even when there are more people off work than in work and more people needing care than can care. Watch the debt build up while public services and society start to collapse.

Progressive step 5: Indulge in repeated reorganisations of the health, care, education and welfare systems so people think you are getting a grip. Produce long complicated plans for reform that will never be implemented before they are overtaken by political change and/or further service collapse. Look busy reorganising the chairs on the policy deck and hope that no one notices the ship going down (and if it does, that it’s not on your watch!)

Progressive step 6: Launch new progressive causes to which people can attach themselves. Be ready to do this with increasing frequency as the problems get worse. Stoking fear and anger about things like climate collapse, colonial history, racism, biological sex and deadly disease shows you what can be done.

Progressive step 7: Ensure the progressive light shines until there’s no sanity left and no-one knows what is right.

Being an autism parent means you see the dark side of the progressive lies that are told. You come to realise the power of Lent.

This Lent please pray that future generations are spared the same fate.

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The same approach was evident this week when the government published their long-awaited White Paper – Every Child Achieving and Thriving.

On Monday 23 February, the Secretary of State for Education, Bridget Phillipson MP, launched the plan that stretches to 118 pages of government speak. If that wasn’t enough, it was accompanied by another document inviting further consultation on the proposals for SEND reform that will run until May and will likely not report until the start of another school year. The document inviting responses is even longer than the White Paper itself.

The whole thing has an air of magic about it. There is almost no contact with the reality of trying to educate the growing numbers of children with special educational needs nor with the challenges of inclusion in large mainstream schools.

Remarkably, neither document has anything to say about the underlying causes of rising demand. We know it is autism, Speech, Language and Communication (SLC), Emotional and Mental Health (EMH) that is driving up the demand (and I’ve included some new data at the end of this post). Yet there is nothing about WHY the incidence of these conditions is rising so fast nor WHAT is involved in teaching such children, nor WHY so many require high level support.

There is just one half-sentence buried on page 12 of the consultation document that tamely suggests: “we know needs have increased worldwide, in part through better identification.”

It is blindingly obvious that rising demand for SEND and the escalating costs of provision have prompted the White Paper. These trends have exercised politicians, policy makers, think tanks and journalists – as well as teachers - for months if not years.

And yet, when it comes to publication day, there is no mention of what is going on bar repetition of the usual rubbish that it is about better identification - which implies teachers would have missed these children in previous years – as well as a nod to the fact that other countries have the problem as well!

The White Paper completely avoids the large elephant sitting in the middle of the magic show but it has much to say about the additional duties that schools and teachers will have to take on.

Over the coming years, every mainstream school (of which there are about 24,000 in England) will be expected to do much of the following:

Ensure all teachers (almost half a million of them) have additional training in SEND.

Identify all children with SEND and take on a new statutory duty to write Individual Support Plans (ISPs) that are regularly reviewed and logged on a new digital record system that is accessible by other schools, professional services and local authorities.

Determine whether each child with SEND requires basic level ‘Targeted’ support or ‘Targeted Plus’, comprising higher demands.

Create new physical spaces and provision – called Inclusion Bases – in all secondary schools. The most basic will be called Support Bases, supporting children with additional needs, funded by schools. More advanced Specialist Bases, will be for those on Targeted Plus and will attract some additional funding from Local Authorities as well as being supported by experts from the outside.

Work with new teams of experts - largely Educational Psychologists and Speech and Language Therapists – who are to be hired by local Integrated Care Boards (ICBs which fall under the National Health Service) as ‘Experts at Hand’ to provide school support.

Share SEND expertise with other schools as part of existing or new school structures.

Retain the option to request an Education, Care and Health Plan (EHCP), funded and overseen by the Local Authority, but only for cases of the greatest complexity where a child is likely to need a specialist school (and the criteria involved have yet to be shared but support will be standardised in what are to be expert-developed ‘Specialist Support Packages’, with expectations that there will be seven of these).

Sharpen up the complaints process to allow parents to raise SEN concerns, without involving tribunals.

Publish an Inclusion Plan and collate data to reflect activity and performance in relation to SEN outcomes that will be scrutinised by Ofsted.

Despite the ongoing consultation, the legislation is expected to be fully effective by the school year starting in September 2029. At that time, any children with an Education Care and Health Plan (ECHP) who are moving from primary to secondary school or from secondary into post-16 the following year, will be reviewed. About half of all current ECHPs (278,200) cover children in mainstream schools and these are likely to be severely squeezed in review.

Going forward, the government want to retain EHCPs only for children with the most complex needs (although the criteria for this are still yet to come).* EHCPs will carry on being funded by local authorities and it is not clear if central government will help with these costs. Indeed, there is remarkably little in the White Paper and consultation about special schools.

You wouldn’t know it, but there are currently about 170,000 pupils in special schools and demand for places has exceeded supply across the country for years. The private sector has been providing additional capacity to help meet demand. While the White Paper includes an ambition to cap the costs of this private provision, there is no recognition of the knock-on effects if this space was to go.

Although it is buried in the minds of ministers rather than being clearly articulated, the expectation must be to move some of the children who are currently in special schools, and those who are assessed to have similar levels of needs in the future, into mainstream provision. This is a very big ask.

In his journey through the education system, our son with severe autism who is now 22, attended two mainstream primary schools, one private specialist primary school, and two local authority special schools. We also ran an Applied Behaviour Analysis (ABA) programme at home for the years when he was in mainstream school, funded by us.

We all tried very hard to teach him to read, to write and to learn. What went in one day, was lost on the next. His learning difficulties prevented him for engaging with most of what went on school – including the specialist schools. What’s more, a school classroom is just about the worse possible place for a child with severe autism who is wholly unmotivated and unable to learn, and struggles with noise.

The White Paper contains no insights into the challenges faced in teaching children on the frontline of SEND – where most of the money is spent. We are told that more children need to stay in mainstream. That teachers will be trained and experts brought in, but we know that no-one really knows how to teach children with severe learning difficulties. It is a very hard thing to do.

What’s more, much of the school day is necessarily spent helping with basic care such as feeding, toileting and managing comorbid health conditions such as epilepsy and anaphylaxis. Special schools are used to providing this level of care, and they safeguard the children involved. Mainstream schools are already facing significant behaviour challenges with high rates of disciplinary action and low rates of attendance. Including more children with SEND, particularly those with much higher levels of need, will add further pressure and make things much worse.

School leaders are being asked to do all this new work – and to manage all this change - on top of everything else they are expected to do. As ever with Government announcements, there is some magic money floating about with a billion for this and a billion for that but stretched across the school estate and given the trend of increased demand, it will be a drop in the ocean and wholly insufficient to delivering change.**

In addition, any parent of a child with SEND knows how hard it is to access expert support from Educational Psychologists or Speech and Language Therapists and the government is proposing to magic up teams of these people, out of thin air; it just can’t be done.

Although it doesn’t feature in the White Paper, data collected by the Department of Education, shows the scale of the problem, captured below.

The percentage of all pupils who have ECHPs is now at least 5.22% (1 in 20) in primary and 6.12% (1 in 17) in secondary age groups in England (for 2024-5). These rates have gone up dramatically since 2015 and particularly so amongst primary school kids. The majority of awards are now made for autism, SLC and SEMH – the rates of which have all more than doubled in both age groups over this time. The problems are real and severe and only ever increase.

% of all pupils in the cohort showing the rate of those with EHCPs and the main conditions for which they are granted (autism; social, emotional and mental health (SEMH); speech, language and communication problems (SLC)) for England, 2015-6 and 2024-5, primary and secondary cohorts (townhalldata.com using DoE data see: https://explore-education-statistics.service.gov.uk/find-statistics/special-educational-needs-in-england/2024-25#explore-data-and-files)

Ultimately, there is only one way to tackle the crisis in SEND.

We have to face up to the causes of SEND.

No amount of magical thinking can wish them away.

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*Remarkably, the White Paper says this in regard to those currently in special schools with EHCPs at the moment: “We … recognise that, for a small number of children and young people who have very low incidence, high complexity needs, regional variations in commissioning and the location of settings and services can make accessing the appropriate support more difficult. In some local authorities this may involve one or two children or young people requiring this level of support, while others may have none”(p.65). Given that there are currently hundreds of children in local special schools at the moment, this implies that most of these children – including those with VERY severe levels of need would be educated in mainstream schools in the future. Children like my son would be one of them. When he was in mainstream school, he spent most of his time in the playground running around with the other boy with severe autism. It was not the fault of the school or the staff, who were doing their best. It was just not possible to keep him sitting at a desk and doing normal school work during the day.

**for people with an eye to the budgets, the announcement included up to £7bn of funding comprising: £20M for teacher training in SEND; £1.6bn for an Inclusive Mainstream Fund (some of it coming from money currently given to Local Authorities for high needs support via EHCPs); £1.8bn for the Experts at Hand service (managed by the ICBs/NHS); and £3.7bn for making the school estate accessible and providing more physical spaces for teaching in inclusion bases. In addition, “From 2027, we will consider transitional arrangements that local areas can take to further increase the amount of funding that mainstream schools receive to provide SEND support directly, in advance of statutory changes.”(85)

On one hand, we have the status quo, backed by the World Health Organisation and most national governments including the UK.

On the other, we have the agenda being pioneered by the movement to Make America Healthy Again. If sustained and successful, the latter will have an impact beyond anything else underway in contemporary politics. Its legacy will be realised in the health of people who are yet to be born.

In 2035, university students studying social science, public policy and public health will be asked to look back on the previous decade and ‘Compare and contrast policy responses to the crisis in child health in the United Kingdom and the United States, exploring health outcomes for the next generation.’

The smart student will begin by outlining what we mean by the ‘crisis in child health’. They will consult professor google (or more likely a very sophisticated AI programme) to find useful facts and figures in relation to child health in each jurisdiction for 2025.

It should shock them to find that in both countries more than a third of young people had a long-term health condition or disability including diabetes, asthma, heart disease, epilepsy, arthritis and autism.

The most recent figures for England were included in a report published by the Kings Fund in November last year:

The report opens with the devastating news that rates of infant, child and adolescent mortality have risen since 2020, and now exceed all other countries in Europe.

The average height of our children (a good proxy for development) is also falling relative to other parts of the world.

And when it comes to lifelong conditions, allergy is at the top of the list. As many as 40% of all children have a diagnosed allergy to food or other substances causing eczema, asthma, rhinitis and anaphylaxis. There are also frightening rises in rates of autoimmune disease including coeliac, inflammatory bowel disease and diabetes.

It is well known that there have been shocking rises in mental disorders such as OCD, self-harm, depression and anxiety. Recent data from the Royal College of Paediatricians and Child Health (RCPCH) indicates that “almost one in in five (18%) children aged 7-17 has a probable mental disorder, a 50% increase from 12% in 2017”.

Rates neurological disorders such as autism and ADHD are poorly represented in national statistics – which makes me very suspicious – but these problems show up in the data for Special Educational Needs and Disability (SEND) collated by schools and local authorities. The number of children who are sufficiently disabled to warrant an Education Care and Health Plan (ECHP), many of them for autism and associated learning difficulties, now exceeds half a million, with rates going up very fast. Furthermore, there are very large numbers of people waiting for assessment and diagnosis, often for years.

The US has a similar profile. They too have rising numbers of children with life-limiting chronic health conditions who go on to join the benefit queue. They are also seeing rising rates of immunological, neurological and mental health disorders, now affecting more than 40% of their youth.

Temporal Trends (2023 vs 2011-2012) for 15 Chronic Conditions Among 3- to 17-Year-Old Individuals in the US

Forrest et al (2025): The NSCH used parent-reported information to identify children with a chronic condition, while PEDSnet was based on clinician-recorded diagnoses in electronic health records. The annual prevalence of 15 conditions was computed by dividing the 2023 rate by the 2011-2012 (NSCH) or 2011 (PEDSnet) rates. A rate ratio of 1.0 means that the rate between the 2 time periods did not change. Anxiety had the largest increase, while asthma decreased in both data sources.

This study concludes with the sobering words that: “child health in the US has been declining in multiple domains over a 17-year period from 2007 to 2023. This comprehensive evidence of deterioration highlights the importance of identifying and addressing the root causes of this fundamental decline in the nation’s health.”

In the UK, the epidemic of chronic health conditions – in adults as well as children – appears most prominently as a problem for the public accounts. Ministers are grappling with this in relation to rising welfare spending, increased demand and escalating costs for SEND, and the bottomless pit of the health service. In each case, they try to make cuts or efficiency savings only to be steamrollered by real and rising demand – and public anger - that can’t be ignored.

Last year, the Labour government tried to cut spending on the Personal Independence Payments (PIP) given to disabled children and adults, only to roll back and have a review.

This year, we are waiting for a long-promised and much-leaked reform of the SEND system, which is similarly doomed to failure before it appears. Bereft of ideas, ministers are promoting more inclusion which has long been the preferred policy, with reduced legal entitlements which are to be delayed until the next parliament so someone else gets the blame!

There is also an ongoing independent review into the assessment and prevalence of autism, ADHD and mental health disorders. Led by Professor Peter Fonagy, this review aims to find out more about the rising numbers of cases and how to curb the demand, but it will take months or even years, and is unlikely to achieve any change. After all, the experts hearing the evidence are the very people who have overseen the decline in children’s health. They too are bereft of ideas.

Each area of policy-delay-by-review is premised on the assumption of overdiagnosis and driven by the need to make cuts. None aims to understand the root causes of the problems and from there, work out what can be done to prevent them in future. Despite being focused on health, the reviews are NOT addressing the biology of the problems being discussed.

Indeed, it is striking that when they DO talk about causation, policy researchers, experts, media commentators and politicians reach for a ready list of explanations that sound plausible (and kind) but are never related to the underlying biology. They start with what are referred to as the social determinants of health – a fancy phrase for societal influences such as poverty, inequality, obesity, young mothering, old mothering, low levels of education, social media use, access to health professionals and even vulnerability to so-called conspiracy theories (such as resisting vaccination). It is striking that there is never any appreciation of basic biology in this approach.

As a good example, the think tank Policy Exchange just put out a paper suggesting that there must be a middle-class conspiracy to defraud the state and get Jemima more time exams because rich areas spend more per capita on SEND than is the case in poorer locations. The authors make an a priori assumption that SEND needs are inversely related to social class and never consider that the lack of a social and spatial gradient might tell you something important about biology.

People fail to recognise that ALL children are vulnerable to immune assault, neurological disorders and chronic ill-health, regardless of class. There is no appreciation that biology runs deeper than class.

What’s more, because the middle classes tend to be more compliant when it comes to government orders, it is perfectly plausible that iatrogenic health conditions (associated with increased toxic exposure and pressure on the immune system) are positively correlated with social hierarchy. Added to which, it costs more to transport children to special schools in rural than urban areas and this might add a considerable amount to the spending on SEND.

The Americans are taking a very different approach. They aren’t trying to explain away the problems and have recognised the biological peril they face. They have formulated a comprehensive centralised policy agenda to deliver on political promises to Make America Healthy Again (MAHA). This involves a long list of initiatives around quality food production, diet advice, reducing environmental pollutants, promoting exercise, improving school meals, stronger regulation of medicines and vaccines, reducing drug exposures and the redirection of scientific research.

In just a year, MAHA has launched a remarkable programme for change and is moving very fast to deliver. There’s an upbeat video available on the MAHA website that directly challenges the food industry on sugar and chemicals, as well as the pharmaceutical companies for mis-selling, regulatory capture and control. There is a determination to reduce the toxic burden borne by their kids. Most exciting for me, there is significant investment now going in to researching the causes of autism and related neurological damage as well as efforts to find possible treatments and identify ways to protect the next generation.

New people have been appointed to the leading health regulatory and policy bodies to scrutinise rather than rubber stamp health decisions. These bodies have already stopped automatically authorising new vaccines and have reduced the number of vaccines on the childhood schedule by up to 50%. There is a team looking at the cumulative effect of the adjuvants in vaccines (focusing on aluminium) and there is much more to come.

In the US, there is:

National leadership with a clear agenda to reduce the burden of toxic exposures from food, the environment and medicines.

A commitment to identify the causes of chronic ill health as well as treatments for those already affected.

Intellectual freedom to challenge dominant narratives in research and clinical practice as well as a move away from mandated health interventions.

In the UK, there is no singular focus on understanding the root causes of children’s ill-health. Policy is largely focused on crisis management and the need to curb spending. In addition, much of the detail is devolved to arms-length, largely unaccountable, health bodies and quangos* (such as the UK Health Security Agency (UKHSA), the National Institute for Health and Care Excellence (NICE) and Medicines and Healthcare Products Regulatory Agency (MHRA)). Each body looks after a small area of policy and is vulnerable to capture by a complacent self-electing elite.

There is also a plethora of non-governmental organizations such as Royal Colleges, think tanks and universities that regularly issue reports and calls for action over child health, but none of them have the power to act. They ALL push the social rather than biological model of child and public health but calls to reduce inequality or social media use ring rather hollow when up against the deterioration of immune and neurological health.

By the end of the coming decade, it will be easy to compare the outcomes of the American and British policy duel over improving child health.

Data documenting rates of allergy, autoimmunity, neurological disorders, mental health and physical fitness should provide proof of the public policy pudding. There is every chance that the MAHA movement will have reversed the decline in children’s health and if so, it will be hard for others to not do the same.

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*Quango stands for Quasi-Autonomous Non-Governmental Organisation

However, the fact that it did, points to something that needs to be said.

I can’t be the only parent of a child with severe autism who sometimes dreams of finding a magic pill to calm everything down.

The devil whispers in your ear in the small hours of the morning when you can’t sleep because of the noise your offspring is making. He’s back whispering when you want to join in with other people at a social event, but you can’t. He even recruits foot soldiers in your family and community who advise you to stop holding out. They confidently tell you that there must be a magic pill out there to calm everything down.

Even though we know that ‘health’ interventions made our son sick, we can all-too-easily reach for more when times get hard or expectations are high. We are vulnerable to the seductions of the pharmaceutical industry even when we know what they do. It is easy to be sucked into iatrogenic markets for medical products that are very bad for our health. And once sick, you are in greater need of some help.

Last week I found myself lying on a cold tiled floor next to our precious son who looked like he was dying. He was having a full-blown seizure in front of our eyes. His face was the palest it has ever been. His eyes were rolled back. He was covered in sweat. He was foaming at the mouth. His body was shaking. He had blood on his temple and the back of his head due to hitting the corner of the wall and a cupboard when he fell. It was truly terrifying.

I’ve been having flashbacks ever since. I can’t think about it without my heart racing, my toes curling up and anxiety hitting my stomach. I really thought he was going to die.

My heart goes out to all the autism parents whose children suffer like this over and over and over again, year after year after year.

We were in Lanzarote and it was the final day of a three-week holiday. The seizure came out of the blue just before lunch. He had a second, about 8 hours later when sitting on the sofa after his tea. We got him to bed and sat holding his hand as he slept and we wept.

My husband and I went into panic and shock.

Our first fear was that he would die in the night.

Our second, that we wouldn’t be able to get him home on the plane the next day.

Our third, that this was the new normal for our wonderful son. Would he be struck down by seizures for the rest of his life?

It was only after getting home that we had the time to try and understand what had happened and why.

We made the terrible decision to take the drug lorazepam with us on holiday. We were given it by the doctor for ‘emergency use’. We were seduced by the idea that there was an easy way of calming things down. We should have known better.

It turns out that seizures are known to be a rare ‘paradoxical reaction’ as well as a dangerous side effect following withdrawal of lorazepam.

In the second half of the holiday, we saw all the usual behaviours associated with dysregulation developing in our son. His ‘autism’ was getting worse. This started with putting his fingers in his ears, making loud noises and running fast. Then the insomnia kicked in. When he woke in the early hours and couldn’t go back to sleep, we remembered the pills. We tried one and it worked very well. When the noise happened again the following night we resisted and sat it out, but the next night we went for the pills.

Without thinking about it properly, and not seeing any obvious negative side effects, we ended up using nine 1mg doses (well within the recommended dosing limit) on 7 nights across an 8-day period. After stopping the drug on the 9^th day, we had the seizures the following day (about 60 and 68 hours after the last dose). This short treatment period was enough to accustom his brain to the calming effect of the drug and without it, he went into seizure.

Lorazepam is a fast-acting benzodiazepine that is used to treat seizures, agitation, anxiety and insomnia. It works by increasing the effect of Gamma-Aminobutyric Acid (GABA) - the primary inhibitory neurotransmitter in the human body.* While GABA calms the brain it also improves bowel motility and that week, our son went to the toilet every morning as though it was the most normal thing in the world. We stopped using his usual laxative (oxypowder) and put it down to being away rather than associating it with the GABA effect.

I know it’s a ridiculous cliché as it should never have happened, but we are now trying to learn from the horror. The experience has taken us back to some fundamental questions about the role and significance of neurotransmitters in explaining the behaviours and comorbidities associated with autism. It’s highlighted how imbalanced his system must be.

As ever, there is a mountain of research evidence about the role and significance of GABA in the pathophysiology of all the major neurodevelopmental, neuropsychiatric and neurodegenerative conditions such as autism, schizophrenia and Alzheimer’s disease. Research has highlighted a mismatch between the Excitatory/Inhibitory (E/I) balance – reflected in low levels of GABA relative to glutamate – in all these conditions.

When the conversion of glutamate to GABA is inhibited or the enzymes involved in the creation or breakdown of these compounds are dysregulated, or the body’s GABA receptors are blocked, an individual will struggle to regulate their neurological function. The timing and context of change will determine the nature and progress of the disease. The E/I switch in early life underpins autism and ADHD, while in later life, it is part of the pathology of schizophrenia or Alzheimer’s disease.

God didn’t design us this way. Something is turning the switch. This rewires the neurological system, and it is very hard to reverse.

A recent review of the research on the role and significance of GABA in Autism Spectrum Disorder (ASD) published in Frontiers in Psychiatry (2025) documents what we already know:

The authors reiterate the key finding that people with autism have abnormalities in the neurons, neurotransmitters, receptors and enzymes that should reduce neuronal excitability and maintain brain stability: ASD is associated with abnormal GABA levels in the brain and the blood.

This, in turn, reflects a disruption in the normal development of GABAergic neurons in early life. The disruption produces an ongoing imbalance between excitatory (mainly glutamate) and inhibitory (mainly GABA) neurotransmission which is called the Excitation/Inhibition (E/I) imbalance. This structural disruption and associated biochemical change impacts on synaptic pruning, plasticity, learning, memory and behaviour. The changes have knock-on effects on brain energy and biochemistry. It explains the core symptoms of autism such as social communication difficulties, repetitive behaviours, and sensory abnormalities.

There have been animal studies and limited human trials of a new generation of GABA receptor agonists (and examples include baclofen and clonazepam (another benzodiazepine)) to treat autism. There are also ongoing investigations into drugs such as bumetanide that affect chloride ion channels, increasing the inhibitory effects of GABA. However, the results of research trials have been mixed, likely in part due to poor screening of recruits and the failure to identify those most likely to benefit.

Figure 3 Wang and Sun (2025, 15) full explanation in the published account.

Given our experience with lorazepam, you might think it would come with a red alert on the front of the box. I wish that it had.

You also might imagine that the drug is rarely used. I wish that it was.

It turns out that more than 1 million scripts were written for the drug in England in 2021 and this was lower than had been the case in the past (in part due to challenges with manufacture and supply).

The Yellow Card Reporting system where people log adverse reactions to drugs includes as many as 3,682 reports between 1973 to 2025, 67 of them fatal. Rather alarmingly, the number of recorded adverse reactions has increased over time:

More evidence of the risks is buried in the annual reporting of deaths related to drug poisoning produced by the Office for National Statistics for England and Wales.

These reports use death certificates to generate the data, identifying cases where any particular drug has been mentioned at death. About half of the 5000 annual deaths are due to opiate use – and misuse – but benzodiazepines feature in the small print alongside a number of other widely-used drugs.

Some of these deaths will involve people with autism and in 2020-1, almost 10% of patients with autism and a learning disability in England were prescribed benzodiazepines including lorazepam for anxiety, challenging behaviour and otherwise unspecified reasons.

The National Health Service (NHS) has a long-running campaign to try and reduce the use of these drugs to treat people with autism and learning difficulties. Called STOMP (Stopping over medication of people with a learning disability and autistic people) and STAMP (Supporting treatment and appropriate medication in paediatrics (STAMP), the campaign is now included in the current NHS Ten Year Plan.

As ever, however, we are engaging in double-speak when it comes to understanding and treating autism.

On the one hand, it is widely argued to be a ‘difference not a disease’ which implies there is nothing to treat. On the other, people living with autism need help to manage their symptoms and they turn to doctors who prescribe them drugs as best as they can.

On the one hand, doctors and policy makers want to reduce the use of potentially dangerous drugs in a population who are already struggling and may not be able to describe their experiences – so they sign up to STOMP. On the other, they are supporting patients and their families with the symptoms of severe autism, and they hear their desperate cry for help.

On the one hand, we try to treat the symptoms of autism, often exposing people to very dangerous side effects. On the other, no-one ever asks WHY we have so many people suffering in the first place and what can be done about it.

Patients, families, doctors and care providers are tied up in a land of double-speak that stops us talking about the very things we need to be talking about. It leaves patients and parents vulnerable to the Devil whispering in their ear as he did to us on holiday when we were hoping for peace.

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*As Microsoft’s Co-Pilot AI system explains:

Here’s a clear biochemical explanation of how lorazepam can trigger serious withdrawal symptoms — including seizures — even after low‑dose use for only a week, based on the most relevant information from the search results.

Why this can happen: the neurobiology in simple terms

Although seizures are more common after high‑dose or long‑term benzodiazepine use, they can still occur after short-term, low‑dose lorazepam because of the drug’s potency, short half‑life, and the brain’s rapid neuroadaptation to GABAergic modulation.

1. Lorazepam strongly enhances GABA signalling

Lorazepam is a high‑potency benzodiazepine that enhances the effect of GABA, the brain’s main inhibitory (calming) neurotransmitter.
Over several days of repeated exposure, the brain begins to adapt.
One reference describes this process clearly: lorazepam enhances GABA activity, and with regular use “the nervous system adapts”. Even with brief but repeated exposure, the brain begins to down‑regulate GABA receptors or alter their sensitivity.

2. Neuroadaptation creates temporary reliance on the drug

Once GABA signalling is artificially boosted, the brain compensates to restore balance (homeostasis). This compensation makes the system less responsive to natural GABA.

So when lorazepam is suddenly removed:

• GABA signalling drops sharply

• The brain has not yet recalibrated

• The result is over‑excitation of the nervous system

This “rebound hyperexcitability” is the root mechanism behind withdrawal agitation, anxiety, and—when severe—seizures.

3. Short‑acting benzodiazepines produce faster, harsher withdrawal

Shorter half‑life benzodiazepines (lorazepam, alprazolam) produce withdrawal that:

• begins sooner (1–7 days)

• can be more intense
  Studies emphasise that withdrawal symptoms are “generally more severe with short half-life benzodiazepines”.

This means that even after a week of daily use, the brain can experience a rapid drop in GABAergic activity the moment blood levels fall.

4. High potency increases the risk of acute loss of inhibition

High‑potency benzodiazepines like lorazepam produce stronger GABA receptor modulation per milligram.
A paper notes that high-potency benzodiazepines carry specific concerns such as “discontinuation syndrome” because of their strong and rapid effects on the system.

This makes neuroadaptation faster and withdrawal more abrupt, even at what seem like low doses.

5. Seizures reflect a severe form of GABA‑glutamate rebound imbalance

During withdrawal:

• GABA signalling drops

• Glutamate, the excitatory neurotransmitter, becomes relatively unopposed

• The CNS becomes hyperexcitable

This excessive excitability can culminate in generalised tonic‑clonic seizures — described in benzodiazepine withdrawal resources as a recognised complication.

Even though more common after long-term use, the same mechanism applies after shorter durations if the individual:

• is sensitive to GABAergic changes

• has a rapid metabolism

• has underlying CNS vulnerabilities

• or simply reacts strongly to lorazepam’s potency

Why some people experience seizures after only a week

Putting the above points together:

1. Lorazepam is potent, so the brain adapts quickly.

2. Its short half-life causes a sharp drop in levels between doses or after stopping.

3. Neuroadaptation can develop in days, not only weeks.

4. Sudden discontinuation produces acute GABA under‑activity + glutamate over‑activity, a known seizure‑triggering state.

This explains why guidelines warn that even brief regular use can cause withdrawal in some people, with symptoms beginning shortly after cessation.

***************

And when I asked: “How does lorazepam enhance the effect of GABA?”
The machine said:

1. Lorazepam binds to the benzodiazepine site on the GABA‑A receptor

Lorazepam attaches to a specific regulatory site located on the GABA‑A receptor, distinct from the site where GABA itself binds. This site lies between the α and γ subunits of the receptor.

2. It acts as a positive allosteric modulator

Lorazepam does not open the chloride channel on its own. Instead, it increases the receptor’s affinity for GABA — meaning that when GABA binds, the receptor responds more strongly.

3. It increases the frequency of chloride channel opening

When both GABA and lorazepam are present, the GABA‑A receptor’s associated ion channel opens more frequently. This allows more chloride ions (Cl⁻) to enter the neuron.

4. Chloride influx hyperpolarises the neuron

The inward flow of negatively charged chloride ions makes the neuron more negatively charged, a state called hyperpolarisation. This makes the neuron:

• less likely to fire an action potential

• less responsive to excitatory neurotransmitters

5. The result is stronger inhibition

Because GABA is the brain’s major inhibitory neurotransmitter, lorazepam’s amplification of its effect produces:

• anxiolysis (anti‑anxiety effects)

• sedation

• anticonvulsant action

• muscle relaxation

Summary (in one sentence)

Lorazepam enhances GABA by binding to a special site on the GABA‑A receptor and making GABA’s inhibitory action more effective — primarily by increasing how often the receptor’s chloride channel opens, which suppresses neuronal firing.

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These are people who avoid taking responsibility or making decisions. They float above the blood, sweat and tears of the people around them.

They are like parasitic wasps, laying their eggs in the lifeblood of an organisation before lying back and waiting for the goods to emerge. In Milan Kundera’s words, they live with an unbearable lightness and float above the good things in life.

I’ve realised this is the perfect way to make sense of the role of medical experts in the autism crisis. Doctors sit at the top of the autism industry. They have control of the process of assessment and diagnosis without bearing any responsibility for what’s going wrong or what to do about it.

Parents who suspect something is wrong with their child are beholden to teams of paediatric neurodevelopmental consultants employed by the National Health Service.

There are very long queues for these services and parents and children can be waiting for years. Without a diagnostic decision, parents will struggle to get the additional support their child will be needing at school. All the bullshit about early diagnosis comes to nothing while you sit in the queue.

Yet the consultants who diagnose autism (and related conditions like ADHD) do so on the basis of psychological and behavioural criteria not medical ones. The so-called ‘triad of impairments’ (poor communication, limited social interaction and repetitive interests) can be just as easily identified by a trained health visitor, psychologist or educational professional. Applying the diagnostic criteria laid out in DSM-5 does not demand medical expertise. I wish that it did.

Our experiences as parents, coupled with a mountain of research evidence, points to autistic behaviours being a manifestation of underlying immune, neurological and energy dysfunction. Yet this is precisely what our medical experts refuse to acknowledge. Remarkably, the neurodevelopment consultants have no interest in the underlying biological processes and mechanisms that give rise to autism symptoms.

On the one hand, the medics are there policing the process and on the other, they are missing in action. When it comes to exploring, explaining and treating what’s wrong they have nothing to say. They are present and yet strangely absent at the same time.

In this, they are backed up by the army of regulators who control what they do. Indeed, the National Institute for Health and Care Excellence (NICE) has devised guidelines for the assessment and diagnosis of children with autism that instruct hospital leaders and clinicians NOT to do any routine medical examinations – deviating only when it comes to suspected genetic disorders and epilepsy as indicated below:

(NICE CG128)

This remarkable document sits counter to the experience of so many parents whose children are crippled with bowel problems, immune problems, sleep problems and the self-harm that is likely a sign of their pain.

In truth, the medics are there but not there and they should be called to account.

If autism is NOT a medical problem, why are they in charge of the process of assessing and diagnosing it?

If autism IS a medical problem, why are they not treating it as such?

How long can we let doctors have so much control without responsibility? How long can they avoid accountability for what they are doing? How is it possible to leave them sitting pretty while our children suffer so much?

The government has just commissioned an independent review into the assessment and diagnostic processes for autism, ADHD and mental health problems. It is to be headed by Professor Peter Fonagy and involves Sir Simon Wessely and Professor Gillian Baird. They could start by addressing this mess.

While children, families, schools, councils, communities and budgets burn due to the rising costs of neurological disorders, the medical establishment sits pretty, looking down from on high, securing control over those golden tickets that take so long to arrive.

What’s more, once the diagnosis is done, the chocolate factory depends upon an army of non-medical people and services who are deployed to provide care, special education, payments for the loss of parental earnings and additional costs. Given the rising numbers of children affected, this has massive costs for us all. Those costs are enlarged by the absence of any treatment for the medical comorbidities that are overshadowed by the autism tag.

Sooner or later the medics need to be called to HQ for a rollocking. They should be told to make a contribution to understanding and treating the condition or relinquish control. They further need to be told to stop attacking the brave doctors who do try to do the right thing and find out what’s wrong with our kids. They also need to open their minds to the environmental threats that are challenging our immunity and causing the problem in the first place.

The medics are living too lightly when it comes to the autism crisis. Their lightness is becoming unbearable for us all. They need to be brought down to earth or relieved of their role.

This post was provoked by reading the following words on page 24 of the House of Lords report on the Autism Act (2009) where the authors are clearing the ground: “Autism is not an illness”.

My first thought was that we would be better off if we DID think of it as an illness. After all, it comes with conditions (comorbidities) that we DO treat as illnesses – allergies, constipation, insomnia and anxiety. It is also diagnosed by doctors who deal in illnesses.

What’s more, people who want to think of it as being a ‘difference rather than a disability’ are deluding themselves. OR, if they are not disabled by their neurological condition, we need to use different language for the two groups.

Our son has a condition that is better understood as Paediatric Intestinally-Mediated Encephalitis (PIME) and it would be better treated as this. However, he also has ALL the characteristics associated with classic autism. Kanner would spot him in a crowded room in a matter of seconds.

He talks to himself, makes noises, has odd postures including looking at his hands from the left, he sometimes claps and flaps his arms, and will put his fingers in his ears to block out the sound. He appears to be living in a world of his own. Given this, it would be much harder to win people round to dropping the label for him than it would be to relabel a highly successful adult who has a problem making friends. While the latter wears the label with pride and will be speaking for the community in many public forums, they have next to no idea what life is like for my son. It’s a mess and I fear that the mess will get messier before sanity comes.

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Vaccination has been the delivery vehicle for this approach.

The numbers of diseases covered has grown to the extent that children in the United Kingdom might have as many as 62 doses of vaccine against 15 diseases before they mature. This distorts the development of natural immunity and can cause profound and irreversible damage. It has resulted in an epidemic of chronic disease. There is hardly a family untouched by allergy (eczema, asthma, rhinitis and anaphylaxis), neurological disorders (autism, ADHD, dementia) or psychiatric concerns (depression, anxiety, OCD). These life-long conditions are crippling individuals, families, communities and nations. The progressive dream is killing us, slowly.

It is only a matter of time and political leadership before we dismantle this model. There is nothing else that will do.

Vested interests don’t want to hear it – including the family doctors who are paid for every injection – but the big vaccine cull has begun. In America at least.

We need to muster the political might to make it happen in the United Kingdom where the progressives still have free rein to poison us all.

It’s hard to keep up with the Trump administration. Every day he and the team do something remarkable – kidnapping Presidents or deporting thousands of illegal immigrants – all in the blink of an eye. It’s quite something to see an elected politician getting on with what they said they were going to do - people are shocked!

Less than four months ago, Trump, Kennedy and the leadership team at the Department for Health and Human Services (HHS) held their press conference on autism. Trump promised to make autism a top priority for his Presidency. He told us he was backing his people to look at what was causing the problem, find possible treatments and get the rates down.

I jumped for joy, but the dominant response was hysteria or hysterics.

People laughed themselves senseless because Trump advised people to avoid using Tylenol (acetaminophen/paracetamol/Calpol) during pregnancy or infancy, as there were indications it was a risk for autism. They chortled about the idiotic president while they downed bottles of poison, feeling certain that they knew better than Donald J. Trump.

Even our own health secretary - who can’t know a thing about the biochemical implications of taking a drug like acetaminophen during foetal development - took it upon himself to rubbish President Trump, via Lorraine on TV:

The mainstream media, medical establishment and pharmaceutical companies were happy as Larry, thinking Trump was a busted flush when it came to taking them on.

Four months later, however, they are likely not laughing so much; the scale and pace of change has been remarkable. While research into the causes of autism is ongoing, including inquiry into the effect of the cumulative aluminium adjuvant acquired from repeated vaccinations, HHS has already announced very significant reductions in the number of vaccinations recommended for children in the US.

Just like that! The number of shots will be cut by as much as 50%.

Dr Tracy Beth Høeg, MD, Ph.D., Acting Director for the Center for Drug Evaluation and Research and FDA Ex Officio member to ACIP and Martin Kulldorff, Ph.D., Chief Science and Data Officer for the Assistant Secretary for Planning and Evaluation, have overseen the production of a report entitled: Assessment of the U.S. Childhood and Adolescent Immunization Schedule Compared to Other Countries. They have looked at practice in other developed countries and found the US to be an international outlier in relation to the number of diseases and doses recommended in their vaccination schedule.

Looking at comparator nations, they acknowledge widespread consensus in vaccination against diphtheria, Haemophilus influenzae type B (Hib), human papillomavirus (HPV), measles, mumps, polio, pertussis, pneumococcal disease, rubella, tetanus and varicella (chickenpox). However, there is much less universal support for universal inoculation against many of the other diseases on the recommended schedule in the US. The new guidelines suggest that some of these are appropriate for high-risk groups (Respiratory syncytial virus, Hepatitis A and B, Dengue, Meningococcal ACWY and B) and others might be used following discussion with a doctor (Rotavirus, COVID 19, Influenza, Meningococcal disease, Hepatitis A and B).

From 2026, vaccinations against six diseases (hepatitis, influenza, meningitis, respiratory syncytial virus (RSV), rotavirus and COVID-19) will no longer be compulsory. They will no longer be mandated for children wanting to attend nursery, school and college. Furthermore, they will likely not be covered by the Vaccine Injury Compensation Program (VICP) that currently gives the vaccine manufacturers legal immunity for adverse reactions. This changes everything for the doctors involved and is likely to provoke much greater caution in advising their patients about additional shots. It also changes the risk profile for vaccine manufacturers and will likely reduce incentives to develop new products. Most importantly, children in America will avoid as many as 49 doses of virus and adjuvant (including aluminium), that they would otherwise have (as captured in the bottom lines of this table from the report).

Høeg and Kulldorf (2026, 15) NB. red boxes indicate that the vaccine is mandated and dark green that it is recommended for all children and covered by insurance.

In addition, the paper is clear that this is only the start of a process of ongoing review. There is now a commitment to fund “large placebo-controlled randomized trials as needed, both on individual vaccines, combination of vaccines, and vaccination schedules.” Further, the report recommends population-based observational studies that can identify emerging signals of harm following changes in the vaccination schedule, studying:

“the short- and long-term impact of the updated immunization schedule on the targeted infectious diseases, other infectious diseases, acute adverse reactions and chronic conditions such as asthma, allergies, auto-immune diseases, developmental disorders (including ADHD, developmental delay, learning disabilities, intellectual disabilities, speech disorders, and tics), neurological disorders, seizures, diabetes, fertility issues, and eczema. Some important priorities include observational cohort studies comparing health outcomes between vaccinated and unvaccinated children, and if issues are identified, drilling down to evaluate the ideal number of doses, the timing and order of childhood vaccines; interaction effects of administering multiple vaccines on the same day; multivalent versus monovalent vaccines for the same diseases; vaccine adjuvants; and different immunization schedules”.

These changes should trigger some reductions in the rates of chronic disease amongst children and may well sink some of the vaccines that are left on the list. The combined versions of vaccines such as DTaP (Diptheria, Tetanus and Pertussis), the 6-in-1 vaccine (DTaP/polio/Hib/Hepatis B) and MMR (Measles, Mumps and Rubella) are well known – by parents at least - to be triggers for neurological harm and this should show up in rigorous retrospective research.

It is criminal that this ‘gold-standard’ research has never been done.

Although critics have been quick to point out that the new schedule still exposes American children to a very significant number of potentially dangerous doses of vaccine both in utero and from birth, this is a massive step in the right direction.

The contrast with what is happening in the United Kingdom is now very stark. On this side of the pond, the vaccine schedule only gets longer. We are in the dark ages when it comes to scrutinising the rationale for the use and impact of vaccines. There is no public acknowledgement that we don’t have double-blind placebo-controlled trials for these vaccines individually, let alone in combination. Further, we don’t have any understanding of what vaccines do to the microbiome and subsequent immune development and metabolic function of a small child. We have no idea how individual genetics and immune inheritance determine the impact of the vaccines and their long-term consequences. We are literally shooting in the dark with perilous implications for the next generation.

What’s more, the UK is now an international outlier in relation to the vaccines given to children. We are just behind the progressive nations of Canada and Ireland. We start the programme at 2 months and a child will have been given up to 62 shots before turning 18. Just last year, the Joint Committee on Vaccination and Immunisation (JCVI) added MORE vaccinations to the schedule.

From January 2026, children born on or after 1 July 2024 will have an additional (4th dose) of DTaP/polio/Hib/Hepatitis B (hexavalent) vaccine at a new routine appointment at 18 months. They will also have the second dose of MMRV at the same time, rather than at 3 years 4 months as it has been to date. What’s more, this vaccine now contains varicella (chicken pox) and the Americans have raised concerns about high rates of febrile seizures following use.

It is scary but not surprising to find that autism rates track these data to at least some extent.

Denmark, at the bottom of the table with 30 doses for 10 diseases, has childhood autism rates of less than 1 in 66 or 1.5% (still far too high). At the other end of the table: the US had a rate of 1 in 31 in 2022; Canada reports 1 in 66 but the data is very out-of-date (for 2018); Ireland had a rate of 1 in 20 in 2025; and the UK reported 1 in 57 for 2021 although the data is poor and rates are as high as 1 in 17 in Northern Ireland for 2024/5 and 1 in 24 for Scotland in 2023.

Our son had a comparatively small number of vaccinations (by current standards), all given later than advised – 3*DTaP, Polio and Hib, 2*MMR and 1*Meningitis C. This was enough to cause a major regression into severe autism and ongoing allergies, bowel disease, profound learning difficulties, anxiety, OCD, insomnia and self-harm (and the story is here). His immune inheritance in utero (Maternal Immune Activation) and his genetic vulnerabilities, in combination with small size and large immune assault, were more than enough to send him over the edge.

Given the growing length of the vaccine schedule and the increase in rates of maternal immune disorders, among other threats, we should all be very afraid. While we can share our experiences and tell people who want to listen, significant change will need to come from the top - just as is happening in the US. I’m willing them on.

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We desperately need an overhaul in mainstream thinking such that we ask the obvious questions: Why do we have a growing autism problem? What can be done to support those affected? How to save the next generation from the same fate.

Instead, we see the numbers go up, year after year, only to be told these cases don’t count. With straight-faces, experts will repeat the mantras that it is just ‘better awareness’, ‘wider diagnostic categorisation’ and a desire for ‘greater inclusion’. Packaged with the bow of ‘neurodiversity’, the experts are confusing us all.

Sadly, however, the neurodiverse chickens are now coming home to roost in the barns of Whitehall. The government needs to make cuts and if the problems aren’t real, the funding can go.

In the last week, there has been a drip-feed of press articles outlining the likely changes that are coming for children with Special Educational Needs and Disabilities (SEND). We are told that too many children are given support and there is scope for greater inclusion (read cuts).

It is obvious that Ministers, their advisors and experts have no experience of childhood autism. If they did, they would address it as a national emergency. They would also insist on integrating attention to children’s health alongside efforts to meet their educational needs. Without support for their health, there is little chance they can learn.

The rest of this article revisits a survey of parent experiences that was conducted with the charity Thinking Autism just over a decade ago.

We asked parents and carers questions about the problems affecting their children and their experiences of trying to access support for their health.

Our survey was answered by 264 parents and carers of children with autism – an amazing number considering how stretched and stressed we all are.

In terms of the challenges faced, the majority reported a very long list of concerns.

Almost all had significant problems with behaviour such as irritability, agitation, anxiety, lethargy and/or hyperactivity and obsessive speech.

More than half had a significant problem with aggression.

Almost all reported a significant challenge in relation to sensory processing (sound and environment).

The majority reported significant problems with eating, diarrhoea or constipation as well as other gastrointestinal problems, incontinence, acid reflux, mouthing behaviours (chewing clothes/teeth-grinding).

Most had challenges with sleep.

The majority had significant problems with fine or gross motor skills.

As many as a third faced the problem of seizures or epilepsy.

In the open comments box, respondents told us about:

“Hand biting, arm flapping, hitting things and people, posturing after meals, defiance, aggression, oppositional behaviour.”

“Smacking one hand on top of the other and biting his hand or fingers to the point where his skin is now leathery as it hasn’t had a chance to heal.”

“Reflux and diarrhoea from 2-3 weeks old with frequent night waking. A weighted blanket has made a big difference but will still wake 1-7 times at times when feeling anxious.”

“Will not chew or swallow solid foods at the age of almost 5 years, [food] has to be liquidised but [they] will chew anything wooden, metal or plastic.”

“Complete loss of speech at age 2 1/4 coincided with onset of diarrhoea. Sleep problems can mean waking at 3am and not getting back to sleep again.”

These children were obviously extremely unwell and very distressed.

As you’d expect, almost all the parents and carers had approached the National Health Service (NHS) for support but very few were satisfied with the treatment received. Children were left, often for years, in major distress:

“We had horrendous diarrhoea for years, [and are] constantly told it is ‘toddler diarrhoea’ which is nonsense as he is no longer a toddler … he has severe eating disorder … [being] unable to swallow solid foods without choking or vomiting but no help is given. The attitude is very much ‘get on with it’.”

“The NHS seem bewildered – especially the GPs. They assume his gut issues are ‘in his mind’ and ‘part of his autism’.”

We discovered that it was only epilepsy that was taken seriously, and even then, the treatment available often failed to resolve the problems involved:

“My son has had multiple physical problems: chronic constipation, self-harming, food intolerances, epilepsy. Yet it is only the epilepsy which has been taken seriously (although the treatment has been ineffective to date). All his other issues have been dismissed as ‘just autism’ and there has been a reluctance to offer any kind of investigation or treatment.”

In the main, the diagnosis of autism overshadowed any desire to treat the problems encountered. Once labelled autistic, children were left to suffer, and their parents and carers had to find alternative help.

As one parent explained: “When my daughter was small, whatever symptom my daughter was troubled by, her paediatrician would say that it was autism. My husband and I felt like if my daughter was having a heart attack the paediatrician would say ‘that’s autism’. We gave up seeing her and tried to help our daughter ourselves.”

Almost all respondents had tried different ways to help improve the health of their children. Relatively simple diets were the most effective, with almost all reporting ‘significant’ or even ‘life changing’ improvement as a result. To this day, however, the panel of experts constituted by the National Institute for Care and Health Excellence (NICE) to write the guidelines advising NHS staff about support and management for children with autism (CG170) advise against the diets that work:

This feels like more than simple neglect or diagnostic overshadowing and more like deliberate discrimination. There is a willingness to leave our children in pain.

Moreover, when you read parental reports of what dietary changes can do, it is truly shocking that parents are not routinely supported to just have a go, and here’s two examples with many others included in the published version of our report:

“After taking our son off dairy products, at age three and a half, nearly three days exactly to the hour he started naming letters and numbers!! We didn’t even know if he knew them or not although we suspected he did. We didn’t believe in the diet but thought it was worth ‘giving it a go’. Diet and supplements have played a huge part in his life ever since.”

“As soon as I removed gluten and casein from my son’s diet he changed significantly - almost overnight. He went from oppositional, irritable, extremely hyperactive and spacey to much more compliant. School noticed the change instantly. Before removing casein and gluten I was frightened he would run into the road. I used to grab him by the hand to keep him next to me but he used to pull away saying it hurt. He would never ever hold my hand. He said it hurt but I thought he was being difficult! He would either be running ahead of me or lagging way behind complaining he was exhausted and demanding to be carried to school. I kept him in a buggy way past his peers because I was afraid of where he would end up if I let him out. A couple of weeks after removing gluten and casein he was walking to school next to me and then he quietly slipped his hand into mine and held my hand. What more can I say!!”

Our research found that parents were sick and tired of seeing their children suffer and the NHS do nothing or worse in response. They felt that the experts – even those in autism teams - were woefully ill-advised and ignorant about the nature of the condition. Parents were routinely ignored and if anyone listened, it was by chance not design.

Sadly, I fear nothing has improved in the decade since we did the research.

Indeed, as we know, the number of children affected has gone up. The pressure on services has increased. There has been no change in the dominant narrative about the condition and misconceptions about ‘neurodiversity’ have been further entrenched.

Fiddling on the edges of funding for schools will do nothing but make it all worse.

As we remember the ‘wise men’ (Caspar, Melchior and Balhazar), who followed the star and witnessed the arrival of light in the darkness, it is timely to pray for an epiphany about autism.

Our children bring light to the darkness and could help to save the next generation from the same fate.

During Epiphany, people recall the names of the magi and repeat the words ‘Christus mansionem benedicat’ (May Christ bless this house). It is a time to remember and bless the households struggling with autism. Those parents and children are hurting and they need to be heard.

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